Internal Medicine

Grand Rounds

Presentation at Grand Rounds

1.INTRODUCTION » 2. Format of the Presentation » 3. Common Problems

Purpose of Grand Rounds

The purpose of Grand Rounds is to facilitate intellectual debate and mutual learning. Thus the case which is presented must serve as a suitable vehicle for critical thought and vigorous debate. It is therefore essential to realise from the outset that:

  • The actual details of the case itself are secondary to the purpose of encouraging learning and debate.A vigorous discussion from the floor is far more important than a long-winded, even if accurate, case presentation.
  • A case presentation is not a pretext for a didactic lecture or rehash of published information on a particular subject.

If the case presentation is to succeed in its purpose, the following criteria must be met:

1. The case must be well-chosen to illustrate a particular point of interest, and that point of interest must serve as the focus of the actual clinical details.

2. Key people and subject experts must be requested in advance to contribute to the discussion.Thus, if you have a cardiac case, ensure that a cardiologist is present, etc.

3. Sufficient time (at least 12-15 minutes) must be left for general discussion after your presentation.

4. Didactic lecturing and exhaustive literature reviews must be avoided.

5. Registrars must not present material that is better led by an expert in the audience as part of the discussion.

Departmental Rules

The Department has therefore laid down the following rules for registrars presenting cases at Grand Rounds:

1. Title.The subject of the presentation should be clear from the title, except in rare circumstances where the intention is to keep the audience guessing as to the diagnosis during the presentation.

2. Length. Presentations, including your discussion, must not extend beyond 12-15 minutes, thus allowing at least 15 minutes for general debate.

3. Discussion. Registrars are not permitted to monopolise open discussion time with a long discourse. Didactic teaching of any sort under the pretence of discussion is inappropriate. Literature reviews should be extremely brief, must be appropriate to the South African situation and must add materially to the learning experience.

4. Courtesy. Registrars are required to inform all consultants who have had a significant part in the management of the patient that the case is up for presentation, including those who originally referred the patient to the presenting unit.

5. Preparation. Adequate preparation of the presentation is expected. This includes: prior discussion of the presentation with the consultant in charge of the case; previewing of audio-visual material and checking of equipment and live rehearsal to ensure that time limits are not exceeded.