One of the most important skills to learn during PA clinical rotations is how to present patients efficiently and confidently. This can be difficult, because it’s not like anything you’ve done to this point! In didactic year, you spend so much time sitting in a classroom learning about diseases and treatment plans—then clinicals start, and suddenly you’re expected to walk out of a patient room and explain everything clearly to your preceptor in under a minute.
It’s a bit intimidating at first, as not only do you have to remember which questions to ask the patient, you also have to decide which details to include and how to organize everything. The good news is, presentations get much easier with practice. And you’ll get plenty of that, to be sure!
Learning how to do this efficiently was a valuable skill I gained during rotations, and it’s something I use all the time now as a PA in family medicine. If you’re looking for some specifics on how to do presentations, this post is going to review what you need to know about them. I’ll review how to structure them, common mistakes students make, and tips that helped me improve. And I’ll provide you with a patient case presentation template you can use for your own presentations!
Prepping for EORs and want to make sure you’re on track? Check out Blueprint PA’s Rotation Qbank Bundle with 1,750 questions and detailed explanations across your core clinical rotations! 🤓
Why Patient Presentations Matter During PA School
Patient presentations aren’t just a school assignment or something your preceptor makes you do. They’re an important communication skill in medicine!
As a provider, you constantly communicate patient information to other healthcare professionals. Whether you’re talking to a physician, another PA, nursing staff, or a specialist, you need to be able to explain what is going on with a patient in a clear and organized way.
Additionally, your presentations are a window into your clinical reasoning. Remember, your preceptor isn’t just listening to gather facts. They’re trying to understand your thought process.
Your preceptor wants to know the following:
- Can you identify what information is important?
- Can you recognize patterns?
- Can you explain what you think might be going on?
Presentations help you develop these skills, and allow your preceptor to see what your strengths and weaknesses are.
What a Typical Patient Presentation Looked Like for Me During Rotations
During my family medicine rotation, patient presentations became a huge part of my day. I rotated through an outpatient rural health clinic where we typically saw 15 to 20 patients daily. Presentations were generally pretty short because clinic moves quickly. So most of my presentations were under a minute!
Most of the time, I would go into the room before my preceptor, get the patient’s history, and perform a physical exam. Then, after seeing the patient, I’d step out and present the important details to my preceptor before we went back into the room together.
A basic presentation usually included:
- Patient age and reason for visit
- Relevant history
- Important symptoms or findings
- Physical exam findings
- What I thought was going on
- What I thought the plan might look like
The biggest thing I learned was that presentations don’t need to be perfect. They just need to be organized and efficient so your preceptor can understand the case and your reasoning.
The 5 Steps of a Patient Presentation
One thing that helps students early on is having a general structure to follow.
Every specialty and preceptor is a little different, but this five-step format works well for most outpatient rotations:
1. Start with a one-liner.
This is a quick summary of the patient.
Include:
- Age
- Gender
- Relevant medical history
- Chief complaint
Typical format:
[Patient name] is a [age] year-old [gender] with past medical history of [X] here today for [Y].
This immediately gives your preceptor context and sets up the rest of the presentation.
2. Give the history of present illness (HPI).
This is where you explain the story of why the patient is there. You’ll want to include an HPI for each problem the patient is presenting with.
One mistake students make here is giving way too much information. Early on, I definitely struggled to figure out what mattered and what didn’t.
You don’t need to repeat every single thing the patient said.
Try to focus on the details that help explain the patient’s condition using the OLD CARTS format:
O = Onset (When/how the symptoms started, were they sudden/gradual, etc.?)
L = Location (What specific area is affected by symptoms?)
D = Duration (How long do the symptoms last or how frequently do they occur?)
C = Character (What’s the quality or nature of the symptoms? Are they sharp, dull, or burning, etc.?)
A = Aggravating/alleviating factors (What makes it better or worse?)
R = Radiation (Do the symptoms move, or have they spread to other areas?)
T = Timing (Are the symptoms constant, intermittent, or occurring at specific times?)
S = Severity (What’s the intensity of the symptoms on a scale of 1 to 10?)
You should also include any pertinent social history information. Notice how I said, “pertinent?” This is important for any aspect of your presentation. Social history can include anything from a patient’s living situation, employment, drug use/tobacco use, sexual history, suicidality/depression history, or spiritual/religious history.
Use your judgement to determine what is pertinent for the patient presentation!
3. Include all relevant physical exam findings, labs, diagnostic tests, and imaging results.
This includes vital signs. Some preceptors might want to hear all of these, but often preceptors are happy with “Afebrile and vitals signs stable.”
If the patient is there for abdominal pain, your abdominal exam matters a lot more than mentioning every normal finding from other systems. If the patient is there for HTN, the blood pressure reading is an important finding to report.
Also, make sure you review important labs and tests for a patient. For example, if a patient is there for a diabetes visit you should include pertinent results for this. When was their last A1c? What did their last cholesterol labs look like? When was their last microalbumin/creatinine ratio?
4. Give your assessment.
This is the part where you explain what you think is going on. Organize this by each problem the patient presents with.
Your physical exam findings should support your differential. Even if you’re wrong, preceptors appreciate it when you try to think through the case and give your differential diagnoses.
Your preceptors know you’re there to learn, and many times they’ll talk through the assessment with you. They may ask why you think a certain diagnosis fits the situation better than another diagnosis. These conversations can be super helpful and are great for developing your clinical reasoning.
5. Suggest a plan.
You’re not expected to know every treatment plan perfectly as a student, but you still want to try thinking through the next steps and apply your knowledge!
Would this patient likely need labs, imaging, medication adjustments, a referral, or supportive care?
Even if your plan is incomplete, it helps your preceptor understand how you’re approaching the patient.
Patient Case Presentation Example for PA Clinical Rotations
In case you’re wondering how a case presentation is actually supposed to sound and how long it should be (again, this varies a bit by specialty), here’s an example of one you might give to your preceptor:
“Mrs. Smith is a 68 year old female with a history of HTN and COPD presenting with a worsening cough and shortness of breath for five days. She denies chest pain or fever. She has been compliant with her daily maintenance inhaler but has been needing her albuterol inhaler every few hours the last few days. Using her albuterol helps. She is afebrile and vitals are stable today. Lung exam showed diffuse wheezing bilaterally. I was thinking she has a COPD exacerbation, and I was considering steroids, an inhaler refill, and possibly antibiotics depending on symptom progression.”
That is a very basic example, but it gives your preceptor the important information quickly!
Be prepared to answer questions. For example, they may ask what else was in your differential diagnosis and what information helps you feel that a COPD exacerbation is more likely.
Common Mistakes PA Students Make During Patient Presentations
Now that you’ve seen an example of what a patient presentation should look like, let’s take a quick look at some things you’ll want to avoid.
Common mistakes include the following:
1. Too Much Information
As we’ve already indicated, this is probably the biggest issue when students first start clinicals. You spend so much time gathering information that you don’t want to leave anything out. Presentations are about communicating the “pertinent” details though, not repeating the entire encounter. Keep asking yourself if something is a pertinent positive or negative.
In family medicine, you’ll quickly learn that not every patient needs a giant presentation. Sometimes the visit is straightforward and doesn’t require a lot of information.
Your preceptor doesn’t need every single normal review of systems answer.
Please focus on what is clinically relevant.
2. Sounding Disorganized
When you get nervous, it’s easy to jump from topic to topic. To avoid this, try to keep a consistent format each time you present. (And when you take notes while meeting with a patient, take them in the order you’re going to present them.)
Keeping a consistent format will help you stay organized and make it easier for your preceptor to follow everything.
3. Not Having an Assessment
Forcing yourself to think critically is one of the best ways to grow during rotations. And coming up with an assessment is, to me, one of the best opportunities for growth. Push yourself to try thinking of a couple differential diagnoses and a possible plan even if you don’t know. This will be how you learn.
4. Making Up Information
A huge mistake some students make is feeling they need to make up information. If you don’t know a specific detail, it’s okay to say that you aren’t sure or that you didn’t ask about that.
Make sure you show effort though and say you’ll look it up or go back in and ask the patient. And be sure to follow through if you say you’ll look something up.
3 Tips That Helped Me Improve My Patient Presentations
Obviously, nobody expects you to know everything going into rotations. What people do expect is that you’ll be attentive, learn as much as you can, and try to improve!
Here’s three things that helped me level up:
1. Listen to how your preceptor presented.
One thing that helped me a lot was listening carefully to how my preceptor talked about patients. You start to pick up on how an experienced provider filters information and what’s important. I also learned a lot by watching how he wrote notes and structured assessments.
2. Practice outside of the clinic.
One of the best ways to improve at doing presentations is simply to practice them!
You can rehearse presentations in your head after patient encounters, or even practice presenting cases to classmates.
The more you do it, the more natural it becomes.
3. Learn to accept feedback.
Almost every student gets corrected during presentations. This is normal!
Sometimes your preceptor may want more details. Other times they may tell you to shorten things significantly. Every provider has slightly different preferences and often they’ll guide you in the direction they want.
The ability to adapt is important when it comes to learning how to do patient presentations. Being open to feedback and willing to change will set you on the right path to being a good provider and team player!
Final Thoughts
I hope this post helps you feel less intimidated by patient care presentations. They can feel awkward and overwhelming at first, but over time presentations can become much more natural! Just remember to stay organized, listen carefully to your preceptor for what they want, and do your best.
Good luck on your rotations, and be sure to reach out if we can be of further assistance!
And for more (free!) tips on how to succeed during rotations, check out these Blueprint blogs:
