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 the quality of the presentation (r = 0.09). CONCLUSIONS: 1) The outpatient care 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.
Kihm, JT; Brown, JT; Divine, GW; Linzer, M
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