Case presentation

A case presentation is a formal communication between health care professionals such as doctors and nurses regarding a patient's clinical information.[1][2][3]

Essential parts of a case presentation include:

  • Identification
  • Reason for consultation/admission
  • Chief complaints (CC) - what made patients seek medical attention.
  • History of present illness (HPI) - circumstances relating to chief complaints.
  • Past medical history (PMHx)
  • Past surgical history
  • Current medications
  • Allergies
  • Family history (FHx)
  • Social history (SocHx)
  • Physical examination (PE)
  • Laboratory results (Lab)
  • Other investigations (imaging, biopsy etc.)
  • Case summary and impression
  • Management plans
  • follow up in clinic or hospital
  • Adherence of the patient to treatment
  • success of the treatment or failure.
  • causes of success or failure.

References
  1. "Clinical Vignette: Deciding What to Present | ACP". www.acponline.org. 17 May 2016. Retrieved 2022-08-31.
  2. Williams, Dustyn E.; Surakanti, Shravani (2016). "Developing Oral Case Presentation Skills: Peer and Self-Evaluations as Instructional Tools". The Ochsner Journal. 16 (1): 65–69. ISSN 1524-5012. PMC 4795506. PMID 27046408.
  3. "Teaching tips: Twelve tips for making case presentations more interesting". Journal of Family & Community Medicine. 12 (2): 97–100. 2005. ISSN 1319-1683. PMC 3410129. PMID 23012083.


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