Template For Success: The Medical Student Guide To Presenting During Bedside Rounds
Everyone has their own version of a “template”. At every inpatient rotation, I watched interns, seniors, and fellows jot down notes in their own style. I realized that I started adopting their different styles, but realized that every template has a backbone to ensure success at presenting at rounds. The backbone consists of a simple order of information for every patient presentation. Unlike presenting for a new admission, presentations during bedside rounds tend to focus more on interval events mainly in the past 24 hours, how the patient is progressing, and changes to the assessment and plan based on recent findings.
- HPI – One liner that generally consists of a standard backbone of “Mr. Doe is a XX-year-old male with history of _____ who presented on (date of admission) with ____. “
- Interval events – chronological list of pertinent events that happened since admission
- Overnight events
- Subjective – how patient is doing this morning
- Objective – Vitals, pertinent physical exam findings
- Any new labs and imaging – write them all down, present the pertinent findings. PRO TIP: If you are trending a certain value (i.e. hemoglobin in a patient with a possible acute bleed), present it as higher or lower relative to the last value.
- Assessment and Plan – Do not skip this, and try not to say the same plan as yesterday. Attendings often judge a medical student’s ability to reason by this section.
Other tips to keep in mind:
- It is absolutely imperative to know EVERYTHING about your patient. Although you might not present the patient’s extensive list of medications during rounds, your attending may ask about what medications the patient is currently on. You want to be prepared for these questions by writing them down somewhere.
- That being said, it is perfectly okay and human to miss a detail. If your attending poses a question that you do not know, it is better to be honest and say you will follow up on that. If you round with computers at bedside, you may get a chance to look up the needed information. Do not forget to update the team with your findings.
- LEARN TO ADAPT – Bedside rounds are often dependent on the attending. Sometimes they are table rounds. Sometimes they are less formal and require a short mention of the current status and plan. Rather than being thrown off, learn to adapt by taking cues from the rest of the team.
- For the new patient (or for the new attending):
- Be more thorough with your presentation. You may need to present all pertinent interval events since admission in order to accurately narrate the patient’s story.
- Write notes during rounds. Use a different colored pen to jot down notes that you may need to follow up on.
I hope these quick and easy tips help you shine on your rotations!