The path to becoming an optometrist is filled with many challenges, triumphs, and rites of passage. Overcoming the National Board of Examiners in Optometry (NBEO) exams, clinical proficiency exams, and case report presentations are just a few of the milestones moving toward optometry graduation.
Students typically present case reports during their third-year curricula and throughout externship rotations. This important skill often goes beyond the academic years of optometry school.
In this article, we’ll review tips and strategies to develop a quality case report while delivering an engaging presentation to your audience.
Optometry patient case report preparation
New grad OD’s continue to give case reports in residency grand rounds, journal clubs, continuing education lectures, or even presentations made to congress and legislators. Case report presentations are a culmination of clinical decision-making, professional speaking confidence, and overall acumen.
When selecting a patient to present on, two primary questions should guide you. We will further break these down below.
- What will the audience learn?
- What did I learn?
1. What will the audience learn?
Some presenters have the temptation to dig deep into their patient database for the most unique, rarest case. Clinical pearls, however, can often be gained along a broad spectrum of disease states (not just the rare ones!).
A case presentation can be valuable even when highlighting more commonplace diseases if the management approach is insightful. When selecting a case, it is prudent to find a balance on the continuum between the complexity of the case and the management.
Figure 1 is a graphical interpretation (with example disease states) of the continuum between the case and management complexity.
Figure 1: Courtesy of Tiffany Yanase Park, OD
2. What did I learn?
Like a good cake or bean dip, a good case report will have multiple layers, usually in the form of sequential follow-ups. Consider choosing a case in which you saw the patient at least three times at the initial presentation, follow-up(s), and resolution. Valuable takeaways with high clinician involvement are a vital part of the presentation.
These can include a novel approach to triaging symptoms, a deviation from “textbook” disease presentation, or troubleshooting an atypical response to treatment. A one-visit case or a quick punt to a specialist generally does not provide enough opportunities to showcase in-depth decision-making or clinical pearls.
Download the Optometry Patient Case Presentation Template
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Optometry Patient Case Presentation Template
Use this template as a skeleton to develop a compelling optometry patient case presentation.
Key components of an optometry case report presentation
Every case presentation does not look exactly the same, as each presenter can have preferences for its sequence and ingredients. Sticking to the core sections in the template will help you create a full picture of your patient and frame important clinical messages for your audience.
Selecting a patient case for your presentation
Begin by introducing your patient while maintaining HIPAA privacy (e.g., avoid using patient initials). In unique and easily identifiable cases, obtain a signed authorization from the patient before using the case.
The first visit should be outlined with the chief complaint, pertinent history of present illness, as well as ocular and medical histories. Include all pertinent exam findings, including ones within normal limits. It’s important to have all of the puzzle pieces present so the audience can start forming a clinical picture. From there, you can list out differential diagnoses that could potentially explain your patient’s signs and symptoms.
An extra step to round out your list would also be spelling out the reasons why a diagnosis can be ruled out.
Based on your two-sided list, you can justify how you arrived at the leading differential diagnosis. Your management plan should align with your working diagnosis and justify any ancillary testing ordered, medications prescribed, and your follow-up recommendation.
Nailing down the details
Every follow-up visit thereafter does not need to be described at the same level of granularity, but interval history should certainly be highlighted. It should be clear what has improved or worsened since the previous visit—as this could change your diagnosis and/or provide the rationale for an updated management plan.
The final visit hopefully involves the resolution of the patient’s signs and symptoms, but still, consider the future follow-up plan to monitor for sequelae.
Leading the patient case report discussion
To cover the basics, the presentation should highlight essential elements of the disease entity, such as epidemiology, pathophysiology, or etiology, as well as risk factors.
The management portion of the discussion should address three questions:
- Natural history: What if you did nothing?
- Treatment: What if you did something?
- Prognosis: How likely would the patient's symptoms improve or stabilize if you did something?
Close out the discussion section by looking ahead: call attention to gaps needing more research or feature the latest research study or article. Also, comment on case components that are contrary to existing literature and how this case adds to the general understanding of the disease landscape.
Closing out the patient case report
Create a punchy summary: move away from general messages about the disease state, and highlight lessons learned as related to your unique patient case.
The audience will likely seek actionable steps for patient care, so be sure to highlight how your case impacts clinical practice. Keep it concise with three to four teaching points as a compelling wrap-up to your presentation.
Delivering your patient case report presentation
Keep your audience engaged by modeling your presentation after cinematography. Think of the two sections as two different parts of a movie: the case report section is the live-action sequence, and the discussion and conclusion are the narrated portion.
The case report should be a play-by-play of the clinical findings you acquired. Just like you would not spoil the next scene, allow the audience to synthesize in parallel with the sequence of visits. Your role in the discussion and conclusion would be akin to a third-person omniscient point of view—bring the audience in on what you know and what you learned from your encounters with the patient.
How to nail the discussion portion of your optometry patient case presentation:
- The slides in your presentation should serve as a springboard for your talking points; no one likes a busy or distracting slide!
- Organize information through tables and visual cues like bolding and color accents to emphasize important aspects of the slide.
- Keep your text to the key messages and expand accordingly in your presentation.
Summary
Case report presentations are a great avenue to showcase your learning experience in an interesting patient case. The translational educational value should be evident through your case selection and productive discussion.
A successful case presentation will provide the audience with multiple opportunities to glean important and relevant insights to enhance their clinical practice.
