Improving International Medical Graduates' Performance of Case Presentations

Abstract

Health care professionals use case presentations to communicate patient information among themselves during treatment and management. It is a critical genre of performance for medical residents to master for professional success. This genre is characterized by uncertainty and unique rhetorical moves, grammar, vocabulary and discourse strategies. As the format is established but not universal, international medical graduates (IMGs) in the United States anecdotally report case presentations to be the most difficult of communication tasks due to their lack of familiarity with the genre, problems with grammar and vocabulary, and the inability to organize, summarize or articulate their findings into the prescribed, interactive format. Many report crippling anxiety. For communication skills trainers, reviewing the literature in health communication and applied linguistics greatly informs the training of case presentation delivery. This paper describes the communicative tasks required of residents, followed by the components and genre particular to case presentations and how the task is perceived by residents compared to their attending faculty. Next, it explains the linguistic features unique to the task. Finally, it describes an individualized program established to train IMGs to approach the case presentation with the attitude of confidence and the deliberate manner of speaking required for professional discourse.