Present me a case

Initial situation

Oral case presentation is an essential communication technique in medicine. It is used every day by all medical staff. Patient care depends in part on the effective transmission of the case between different members of the medical staff. However, this skill is little theorized, and little explained to students.

When they arrive at their internship, students often feel helpless and ill-equipped. Based on this observation and their own experience, two medical students have created an e-learning tool that provides students with autonomous and progressive support.

Project implementation

Oral case presentation requires not only clinical reasoning skills, but also intrinsic case presentation skills. Students are expected to fully master this skill when they enter the clinic, to assess their clinical reasoning and patient management. It therefore seems essential to be able to dissociate the bias represented by a lack of intrinsic competence from the clinical skills that teachers must be able to assess. The solution lies in providing additional training. Two students have designed a two-part e-learning space to make this available to everyone, at any time.

The first part of the e-learning program is offered at the start of the master’s program, before students enter the clinic. Its aim is to teach students the purpose, structure and variable use of case presentations in the clinical setting. It includes theory, examples and practical exercises. A downloadable memory card, in the appropriate format, can be slipped into the pocket of students’ white coats to accompany them during their internships.

Once students have acquired sufficient experience and clinical reasoning, they can access the second part of the e-learning program. This involves mastering the case presentation as a working tool - adapting it to the context to better serve their patients and collaborate with colleagues. Students must integrate fundamental notions: the role of interlocutors, the purpose of the exchange and the context in which it takes place. This section also includes theory, practical exercises and a downloadable memory card. This card is an aid to a complete, structured and relevant case presentation, but also a guide to addressing different medical specialties appropriately, by listing the essential elements to be added to the case presentation according to the specialty contacted.

Thoughts and advice

The development of this e-learning was initiated and led by two students. Its greatest interest lies in the fact that it is based on a need they had as learners. It emerged from their own experience of learning this skill. They emphasize the importance of knowing that such a project is possible, that students can get involved in teaching. Their input can be crucial in identifying a gap and responding to it. This “for and by peers” process enabled them to adjust the course to the level requirements needed during the different learning stages. They drew many examples and recommendations from their internship experience, making the content as close as possible to the clinical reality students will face.

The design of the tool was made possible thanks to access to the fee-based rise.articulate platform that a teacher shared with them. This easy-to-use platform makes self-training quick and easy. It has the essential advantage of offering a product that can be easily modified and upgraded according to the feedback received from the various contributors: a section can be easily modified, or a chapter added.

The students’ main advice is to create a highly structured outline of all the knowledge that will appear in the theoretical sections or on the flashcards, before even thinking about the final form of presentation. It is essential to keep in mind the learning objectives and the usefulness of the proposed training.

The theory proposed in e-learning is based on basic medical references. However, as case presentation has been little investigated, and is present in very few books, this content is essentially based on experience. This was a particular challenge for the designers, who did not yet possess this level of expertise when they created the tool. They warmly recommend turning to the right people, daring to contact experienced colleagues, and not being afraid to network. They have, for example, contacted all the specialist departments teaching at master’s level to find out what they are missing in the case presentations made to them by interns.

Student feedback

“Very complete and comprehensible e-learning that allows you to understand what it’s all about and to centralize all the notions necessary for a good case presentation.”

“The e-learning is top-notch, very clear, pretty, allows us to really put ourselves in a situation, especially with the 3 audio exchanges at the end of the first part. What I also find really good are the two documents in pdf format, because it’s something you can save without having to redo the whole e-learning. They’re clear, structured and it’s true that we’ve only had an hour’s lesson on case presentation, whereas, as you explain, it’s really useful.”

“Super super great (I’m looking forward to having the pocket memory aids), very useful to have this e-learning, I feel it’s not seen enough before and during the start of the internships when these presentation moments can be terrifying.”