Learning oral presentation skills: a rhetorical analysis with pedagogical and professional implications

Area of Science:

• Medical Education
• Communication Skills
• Rhetoric in Medicine

Background:

• Oral presentation skills are crucial for physician-physician communication.
• The learning process and value transmission during medical oral presentations are not well understood.
• Rhetoric, the study of communication, offers a novel framework for analyzing medical discourse.

Purpose of the Study:

• To qualitatively explore how medical students acquire oral presentation skills.
• To identify professional values communicated during this learning process.
• To apply rhetorical principles to medical education discourse.

Main Methods:

• A descriptive study utilizing ethnographic observation (160 hours) and discourse-based interviews.
• Observations included 73 oral presentations during an internal medicine clerkship.
• Participants included 12 third-year medical students and 14 teachers at a university hospital.

Main Results:

• Students and teachers differed in their views of oral presentations: students saw them as rule-based data storage, while teachers viewed them as flexible communication for case construction.
• Teacher feedback was often implicit and lacked context, leading to student misunderstandings and potentially impaired communication skills.
• Students acquired unintended professional values due to misinterpretations of feedback, such as devaluing social history.

Conclusions:

• Medical students primarily learn oral presentation skills via trial and error, lacking explicit rhetorical instruction.
• This learning method can impede the development of effective communication and transmit unintended professional values.
• Improving oral presentation education requires emphasizing context-dependent content and making tacit communication rules explicit.