Quantitative analysis of the outpatient oral case presentation: piloting a method

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.

Blinded assessment via audiotape of 36 oral case presentations of new patient evaluations by 23 medical residents.

Outpatient general medical clinic.

Duke University Medical Center medical residents during their outpatient rotation.

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).

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.