QUANTITATIVE-ANALYSIS OF THE OUTPATIENT ORAL CASE PRESENTATION - PILOTING A METHOD

Objective: To measure the content of oral outpatient case presentations and to assess the correlation of objective assessments of this content with subjective ratings provided by the clinic attending physician. Design: Blinded assessment via audiotape of 36 oral case presentations of new patient evaluations by 23 medical residents. Setting: Outpatient general medical clinic. Participants: Duke University Medical Center medical residents during their outpatient rotation. Measurements and main results: Important deficiencies were found in oral case presentation content. Specifically, psychosocial data were often missing (employment history was mentioned in 28% of presentations; illicit drug use, in 17%; household social structure, in 11%; sexual history, in 6%). An assessment and a plan were mentioned only 56% and 69% of the time, respectively. No correlation was seen between an objective "content score" and the attending physician's subjective rating of quality of the presentation (r = 0.09). Conclusions: 1) The outpatient case presentation can be quantitatively assessed in a simple, straightforward manner; 2) outpatient case presentations have important deficiencies in content; and 3) preceptors' evaluations of case presentations may be based upon factors other than content of the presentation.