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The Patient Presentation Rating Tool for Oral Case Presentations

Lewin L, Dolan S, Carraccio C

Composing and delivering effective oral case presentations is an important skill for medical students and residents to learn, but the large variety of patients and presenting problems makes teaching and evaluating this skill complex. Few published tools are available for educators to use, and those that are described are not well-studied. The Patient Presentation Rating (PPR) tool can be used to evaluate oral case presentations, and was developed using focus groups of medical school educators from several medical disciplines including pediatrics, internal medicine, psychiatry, surgery, and neurology. 

The PPR includes 18 items, comprising six sections and an overall rating item. Seventeen of these questions feature a 5-point Likert-type scale with anchors for ratings of 1, 3, and 5. The six sections include history, physical exam and diagnostic study results, summary statement, assessment and plan, clinical reasoning/synthesis of information, and general aspects. Raters use the tool to evaluate live or recorded student patient presentations. 

The PPR has been studied and interrater reliability was found was high both when all items were taken together across the entire measure, as well as within each individual section. In addition, 11 of the 18 items were found to have intraclass correlation coefficients (ICCs) above 0.6, and 10 had ICCs above 0.7. A randomized controlled trial in four US medical schools of using the PPR early in a pediatric clerkship to rate third-year student presentations and give the students feedback showed that this intervention is significantly better than giving unstructured feedback on the quality of student presentations at the end of the clerkship period. 

This tool, although designed and validated for use with third-year medical students, can also be used for fourth-year students, as well as interns. By using the PPR, faculty are able to provide high quality and relevant feedback to individual students.