how to present clinical case study

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Blog Business How to Present a Case Study like a Pro (With Examples)

How to Present a Case Study like a Pro (With Examples)

Written by: Danesh Ramuthi Sep 07, 2023

Okay, let’s get real: case studies can be kinda snooze-worthy. But guess what? They don’t have to be!

In this article, I will cover every element that transforms a mere report into a compelling case study, from selecting the right metrics to using persuasive narrative techniques.

And if you’re feeling a little lost, don’t worry! There are cool tools like Venngage’s Case Study Creator to help you whip up something awesome, even if you’re short on time. Plus, the pre-designed case study templates are like instant polish because let’s be honest, everyone loves a shortcut.

Click to jump ahead: 

What is a case study presentation?

What is the purpose of presenting a case study, how to structure a case study presentation, how long should a case study presentation be, 5 case study presentation examples with templates, 6 tips for delivering an effective case study presentation, 5 common mistakes to avoid in a case study presentation, how to present a case study faqs.

A case study presentation involves a comprehensive examination of a specific subject, which could range from an individual, group, location, event, organization or phenomenon.

They’re like puzzles you get to solve with the audience, all while making you think outside the box.

Unlike a basic report or whitepaper, the purpose of a case study presentation is to stimulate critical thinking among the viewers. 

The primary objective of a case study is to provide an extensive and profound comprehension of the chosen topic. You don’t just throw numbers at your audience. You use examples and real-life cases to make you think and see things from different angles.

The primary purpose of presenting a case study is to offer a comprehensive, evidence-based argument that informs, persuades and engages your audience.

Here’s the juicy part: presenting that case study can be your secret weapon. Whether you’re pitching a groundbreaking idea to a room full of suits or trying to impress your professor with your A-game, a well-crafted case study can be the magic dust that sprinkles brilliance over your words.

Think of it like digging into a puzzle you can’t quite crack . A case study lets you explore every piece, turn it over and see how it fits together. This close-up look helps you understand the whole picture, not just a blurry snapshot.

It’s also your chance to showcase how you analyze things, step by step, until you reach a conclusion. It’s all about being open and honest about how you got there.

Besides, presenting a case study gives you an opportunity to connect data and real-world scenarios in a compelling narrative. It helps to make your argument more relatable and accessible, increasing its impact on your audience.

One of the contexts where case studies can be very helpful is during the job interview. In some job interviews, you as candidates may be asked to present a case study as part of the selection process.

Having a case study presentation prepared allows the candidate to demonstrate their ability to understand complex issues, formulate strategies and communicate their ideas effectively.

The way you present a case study can make all the difference in how it’s received. A well-structured presentation not only holds the attention of your audience but also ensures that your key points are communicated clearly and effectively.

In this section, let’s go through the key steps that’ll help you structure your case study presentation for maximum impact.

Let’s get into it. 

Open with an introductory overview 

Start by introducing the subject of your case study and its relevance. Explain why this case study is important and who would benefit from the insights gained. This is your opportunity to grab your audience’s attention.

Explain the problem in question

Dive into the problem or challenge that the case study focuses on. Provide enough background information for the audience to understand the issue. If possible, quantify the problem using data or metrics to show the magnitude or severity.

Detail the solutions to solve the problem

After outlining the problem, describe the steps taken to find a solution. This could include the methodology, any experiments or tests performed and the options that were considered. Make sure to elaborate on why the final solution was chosen over the others.

Key stakeholders Involved

Talk about the individuals, groups or organizations that were directly impacted by or involved in the problem and its solution. 

Stakeholders may experience a range of outcomes—some may benefit, while others could face setbacks.

For example, in a business transformation case study, employees could face job relocations or changes in work culture, while shareholders might be looking at potential gains or losses.

Discuss the key results & outcomes

Discuss the results of implementing the solution. Use data and metrics to back up your statements. Did the solution meet its objectives? What impact did it have on the stakeholders? Be honest about any setbacks or areas for improvement as well.

Include visuals to support your analysis

Visual aids can be incredibly effective in helping your audience grasp complex issues. Utilize charts, graphs, images or video clips to supplement your points. Make sure to explain each visual and how it contributes to your overall argument.

Pie charts illustrate the proportion of different components within a whole, useful for visualizing market share, budget allocation or user demographics.

This is particularly useful especially if you’re displaying survey results in your case study presentation.

Stacked charts on the other hand are perfect for visualizing composition and trends. This is great for analyzing things like customer demographics, product breakdowns or budget allocation in your case study.

Consider this example of a stacked bar chart template. It provides a straightforward summary of the top-selling cake flavors across various locations, offering a quick and comprehensive view of the data.

Not the chart you’re looking for? Browse Venngage’s gallery of chart templates to find the perfect one that’ll captivate your audience and level up your data storytelling.

Recommendations and next steps

Wrap up by providing recommendations based on the case study findings. Outline the next steps that stakeholders should take to either expand on the success of the project or address any remaining challenges.

Acknowledgments and references

Thank the people who contributed to the case study and helped in the problem-solving process. Cite any external resources, reports or data sets that contributed to your analysis.

Feedback & Q&A session

Open the floor for questions and feedback from your audience. This allows for further discussion and can provide additional insights that may not have been considered previously.

Closing remarks

Conclude the presentation by summarizing the key points and emphasizing the takeaways. Thank your audience for their time and participation and express your willingness to engage in further discussions or collaborations on the subject.

Well, the length of a case study presentation can vary depending on the complexity of the topic and the needs of your audience. However, a typical business or academic presentation often lasts between 15 to 30 minutes. 

This time frame usually allows for a thorough explanation of the case while maintaining audience engagement. However, always consider leaving a few minutes at the end for a Q&A session to address any questions or clarify points made during the presentation.

When it comes to presenting a compelling case study, having a well-structured template can be a game-changer. 

It helps you organize your thoughts, data and findings in a coherent and visually pleasing manner. 

Not all case studies are created equal and different scenarios require distinct approaches for maximum impact. 

To save you time and effort, I have curated a list of 5 versatile case study presentation templates, each designed for specific needs and audiences. 

Here are some best case study presentation examples that showcase effective strategies for engaging your audience and conveying complex information clearly.

1 . Lab report case study template

Ever feel like your research gets lost in a world of endless numbers and jargon? Lab case studies are your way out!

Think of it as building a bridge between your cool experiment and everyone else. It’s more than just reporting results – it’s explaining the “why” and “how” in a way that grabs attention and makes sense.

This lap report template acts as a blueprint for your report, guiding you through each essential section (introduction, methods, results, etc.) in a logical order.

Want to present your research like a pro? Browse our research presentation template gallery for creative inspiration!

2. Product case study template

It’s time you ditch those boring slideshows and bullet points because I’ve got a better way to win over clients: product case study templates.

Instead of just listing features and benefits, you get to create a clear and concise story that shows potential clients exactly what your product can do for them. It’s like painting a picture they can easily visualize, helping them understand the value your product brings to the table.

Grab the template below, fill in the details, and watch as your product’s impact comes to life!

3. Content marketing case study template

In digital marketing, showcasing your accomplishments is as vital as achieving them. 

A well-crafted case study not only acts as a testament to your successes but can also serve as an instructional tool for others. 

With this coral content marketing case study template—a perfect blend of vibrant design and structured documentation, you can narrate your marketing triumphs effectively.

4. Case study psychology template

Understanding how people tick is one of psychology’s biggest quests and case studies are like magnifying glasses for the mind. They offer in-depth looks at real-life behaviors, emotions and thought processes, revealing fascinating insights into what makes us human.

Writing a top-notch case study, though, can be a challenge. It requires careful organization, clear presentation and meticulous attention to detail. That’s where a good case study psychology template comes in handy.

Think of it as a helpful guide, taking care of formatting and structure while you focus on the juicy content. No more wrestling with layouts or margins – just pour your research magic into crafting a compelling narrative.

5. Lead generation case study template

Lead generation can be a real head-scratcher. But here’s a little help: a lead generation case study.

Think of it like a friendly handshake and a confident resume all rolled into one. It’s your chance to showcase your expertise, share real-world successes and offer valuable insights. Potential clients get to see your track record, understand your approach and decide if you’re the right fit.

No need to start from scratch, though. This lead generation case study template guides you step-by-step through crafting a clear, compelling narrative that highlights your wins and offers actionable tips for others. Fill in the gaps with your specific data and strategies, and voilà! You’ve got a powerful tool to attract new customers.

Related: 15+ Professional Case Study Examples [Design Tips + Templates]

So, you’ve spent hours crafting the perfect case study and are now tasked with presenting it. Crafting the case study is only half the battle; delivering it effectively is equally important. 

Whether you’re facing a room of executives, academics or potential clients, how you present your findings can make a significant difference in how your work is received. 

Forget boring reports and snooze-inducing presentations! Let’s make your case study sing. Here are some key pointers to turn information into an engaging and persuasive performance:

• Know your audience : Tailor your presentation to the knowledge level and interests of your audience. Remember to use language and examples that resonate with them.
• Rehearse : Rehearsing your case study presentation is the key to a smooth delivery and for ensuring that you stay within the allotted time. Practice helps you fine-tune your pacing, hone your speaking skills with good word pronunciations and become comfortable with the material, leading to a more confident, conversational and effective presentation.
• Start strong : Open with a compelling introduction that grabs your audience’s attention. You might want to use an interesting statistic, a provocative question or a brief story that sets the stage for your case study.
• Be clear and concise : Avoid jargon and overly complex sentences. Get to the point quickly and stay focused on your objectives.
• Use visual aids : Incorporate slides with graphics, charts or videos to supplement your verbal presentation. Make sure they are easy to read and understand.
• Tell a story : Use storytelling techniques to make the case study more engaging. A well-told narrative can help you make complex data more relatable and easier to digest.

Ditching the dry reports and slide decks? Venngage’s case study templates let you wow customers with your solutions and gain insights to improve your business plan. Pre-built templates, visual magic and customer captivation – all just a click away. Go tell your story and watch them say “wow!”

Nailed your case study, but want to make your presentation even stronger? Avoid these common mistakes to ensure your audience gets the most out of it:

Overloading with information

A case study is not an encyclopedia. Overloading your presentation with excessive data, text or jargon can make it cumbersome and difficult for the audience to digest the key points. Stick to what’s essential and impactful. Need help making your data clear and impactful? Our data presentation templates can help! Find clear and engaging visuals to showcase your findings.

Lack of structure

Jumping haphazardly between points or topics can confuse your audience. A well-structured presentation, with a logical flow from introduction to conclusion, is crucial for effective communication.

Ignoring the audience

Different audiences have different needs and levels of understanding. Failing to adapt your presentation to your audience can result in a disconnect and a less impactful presentation.

Poor visual elements

While content is king, poor design or lack of visual elements can make your case study dull or hard to follow. Make sure you use high-quality images, graphs and other visual aids to support your narrative.

Not focusing on results

A case study aims to showcase a problem and its solution, but what most people care about are the results. Failing to highlight or adequately explain the outcomes can make your presentation fall flat.

How to start a case study presentation?

Starting a case study presentation effectively involves a few key steps:

• Grab attention : Open with a hook—an intriguing statistic, a provocative question or a compelling visual—to engage your audience from the get-go.
• Set the stage : Briefly introduce the subject, context and relevance of the case study to give your audience an idea of what to expect.
• Outline objectives : Clearly state what the case study aims to achieve. Are you solving a problem, proving a point or showcasing a success?
• Agenda : Give a quick outline of the key sections or topics you’ll cover to help the audience follow along.
• Set expectations : Let your audience know what you want them to take away from the presentation, whether it’s knowledge, inspiration or a call to action.

How to present a case study on PowerPoint and on Google Slides?

Presenting a case study on PowerPoint and Google Slides involves a structured approach for clarity and impact using presentation slides :

• Title slide : Start with a title slide that includes the name of the case study, your name and any relevant institutional affiliations.
• Introduction : Follow with a slide that outlines the problem or situation your case study addresses. Include a hook to engage the audience.
• Objectives : Clearly state the goals of the case study in a dedicated slide.
• Findings : Use charts, graphs and bullet points to present your findings succinctly.
• Analysis : Discuss what the findings mean, drawing on supporting data or secondary research as necessary.
• Conclusion : Summarize key takeaways and results.
• Q&A : End with a slide inviting questions from the audience.

What’s the role of analysis in a case study presentation?

The role of analysis in a case study presentation is to interpret the data and findings, providing context and meaning to them. 

It helps your audience understand the implications of the case study, connects the dots between the problem and the solution and may offer recommendations for future action.

Is it important to include real data and results in the presentation?

Yes, including real data and results in a case study presentation is crucial to show experience,  credibility and impact. Authentic data lends weight to your findings and conclusions, enabling the audience to trust your analysis and take your recommendations more seriously

How do I conclude a case study presentation effectively?

To conclude a case study presentation effectively, summarize the key findings, insights and recommendations in a clear and concise manner. 

End with a strong call-to-action or a thought-provoking question to leave a lasting impression on your audience.

What’s the best way to showcase data in a case study presentation ?

The best way to showcase data in a case study presentation is through visual aids like charts, graphs and infographics which make complex information easily digestible, engaging and creative. 

Don’t just report results, visualize them! This template for example lets you transform your social media case study into a captivating infographic that sparks conversation.

Choose the type of visual that best represents the data you’re showing; for example, use bar charts for comparisons or pie charts for parts of a whole. 

Ensure that the visuals are high-quality and clearly labeled, so the audience can quickly grasp the key points. 

Keep the design consistent and simple, avoiding clutter or overly complex visuals that could distract from the message.

Choose a template that perfectly suits your case study where you can utilize different visual aids for maximum impact. 

Need more inspiration on how to turn numbers into impact with the help of infographics? Our ready-to-use infographic templates take the guesswork out of creating visual impact for your case studies with just a few clicks.

Related: 10+ Case Study Infographic Templates That Convert

Congrats on mastering the art of compelling case study presentations! This guide has equipped you with all the essentials, from structure and nuances to avoiding common pitfalls. You’re ready to impress any audience, whether in the boardroom, the classroom or beyond.

And remember, you’re not alone in this journey. Venngage’s Case Study Creator is your trusty companion, ready to elevate your presentations from ordinary to extraordinary. So, let your confidence shine, leverage your newly acquired skills and prepare to deliver presentations that truly resonate.

Go forth and make a lasting impact!

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How To Present a Patient: A Step-To-Step Guide

Last Updated on June 24, 2022 by Laura Turner

Updated and verified by Dr. Lee Burnett on March 19, 2022.

The ability to deliver oral case presentations is a core skill for any physician. Effective oral case presentations help facilitate information transfer among physicians and are essential to delivering quality patient care. Oral case presentations are also a key component of how medical students and residents are assessed during their training.

At its core, an oral case presentation functions as an argument. It is the presenter’s job to share the pertinent facts of a patient’s case with the other members of the medical care team and establish a clear diagnosis and treatment plan. Thus, the presenter should include details to support the proposed diagnosis, argue against alternative diagnoses, and exclude extraneous information. While this task may seem daunting at first, with practice, it will become easier. That said, if you are unsure if a particular detail is important to your patient’s case, it is probably best to be safe and include it.

Now, let’s go over how to present a case. While I will focus on internal medicine inpatients, the following framework can be applied to patients in any setting with slight modifications.

Oral case presentations are generally made to a medical care team, which can be composed of medical and pharmacy students, residents, pharmacists, medical attendings, and others. As the presenter, you should strive to deliver an interesting presentation that keeps your team members engaged. Here are a few things to keep in mind:

• Be confident: Speak clearly at the loudest volume appropriate to protect patient privacy, vary your tone to emphasize the most important details, and maintain eye contact with members of your team.
• Don’t fidget : Stand up straight and avoid unnecessary, distracting movements.
• Use your notes : You may glance at your notes from time to time while presenting. However, while there is no need to memorize your presentation, there is no better way to lose your team’s attention than to read your notes to them.
• Be honest: Given the importance of presentations in guiding medical care, never guess or report false information to the team. If you are unsure about a particular detail, say so.

The length of your presentation will depend on various factors, including the complexity of your patient, your audience, and your specialty. I have found that new internal medicine inpatients generally take 5-10 minutes to present. Internal medicine clerkship directors seem to agree. In a 2009 survey , they reported a range of 2-20 minutes for the ideal length of student inpatient presentations, with a median of 7 minutes.

While delivering oral case presentations is a core skill for trainees, and there have been attempts to standardize the format , expectations still vary among attending physicians. This can be a frustrating experience for trainees, and I would recommend that you clarify your attending’s expectations at the beginning of each new rotation. However, I have found that these differences are often stylistic, and content expectations are generally quite similar. Thus, developing a familiarity with the core elements of a strong oral case presentation is essential.

How to Present a Patient

You should begin every oral presentation with a brief one-liner that contains the patient’s name, age, relevant past medical history, and chief complaint. Remember that the chief complaint is why the patient sought medical care in his or her own words. An example of an effective opening is as follows: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents to the hospital after she felt short of breath at home.”

Following the opener, elaborate on why the patient sought medical care. Describe the events that preceded the patient’s presentation in chronological order. A useful mnemonic to use when deciding what to report is OPQRST , which includes: • The Onset of the patient’s symptoms • Any Palliative or Provoking factors that make the symptoms better or worse, respectively • The Quality of his or her symptoms (how he or she describes them) • The Region of the body where the patient is experiencing his or her symptoms and (if the symptom is pain) whether the patient’s pain Radiates to another location or is well-localized • The Severity of the symptoms and any other associated Symptoms • The Time course of the symptoms (how they have changed over time and whether the patient has experienced them before) Additionally, include any other details here that may support your final diagnosis or rule out alternative diagnoses. For example, if you are concerned about a pulmonary embolism and your patient recently completed a long-distance flight, that would be worth mentioning.

The review of systems is sometimes included in the history of present illness, but it may also be separated. Given the potential breadth of the review of systems (a comprehensive list of questions that may be asked can be found here ), when presenting, only report information that is relevant to your patient’s condition.

The past medical history comes next. This should include the following information: • The patient’s medical conditions, including any that were not highlighted in the opener • Any past surgeries the patient has had and when they were performed • The timing of and reasons for past hospitalizations • Any current medications, including dosages and frequency of administration

The next section should detail the patient’s relevant family history. This should include: • Any relevant conditions that run in the patient’s family, with an emphasis on first-degree relatives

After the family history comes the social history. This section should include information about the patient’s: • Living situation • Occupation • Alcohol and tobacco use • Other substance use You may also include relevant details about the patient’s education level, recent travel history, history of animal and occupational exposures, and religious beliefs. For example, it would be worth mentioning that your anemic patient is a Jehovah’s Witness to guide medical decisions regarding blood transfusions.

Once you have finished reporting the patient’s history, you should transition to the physical exam. You should begin by reporting the patient’s vital signs, which includes the patient’s: • Temperature • Heart rate • Blood pressure • Respiratory rate • Oxygen saturation (if the patient is using supplemental oxygen, this should also be reported) Next, you should discuss the findings of your physical exam. At the minimum, this should include: • Your general impressions of the patient, including whether he or she appears “sick” or not • The results of your: • Head and neck exam • Eye exam • Respiratory exam • Cardiac exam • Abdominal exam • Extremity exam • Neurological exam Additional relevant physical examination findings may be included, as well. Quick note: resist the urge to report an exam as being “normal.” Instead, report your findings. For example, for a normal abdominal exam, you could report that “the patient’s abdomen is soft, non-tender, and non-distended, with normoactive bowel sounds.”

This section includes the results of any relevant laboratory testing, imaging, or other diagnostics that were obtained. You do not have to report the results of every test that was ordered. Before presenting, consider which results will further support your proposed diagnosis and exclude alternatives.

The emergency department (ED) course is classically reported towards the end of the presentation. However, different attendings may prefer to hear the ED course earlier, usually following the history of present illness. When unsure, report the ED course after the results of diagnostic testing. Be sure to include initial ED vital signs and any administered treatments.

You should conclude your presentation with the assessment and plan. This is the most important part of your presentation and allows you to show your team how much you really know. You should include: • A brief summary (1-2 lines) of the patient, the reason for admission, and your likely diagnosis. This should also include information regarding the patient’s clinical stability. While it can be similar to your opener, it should not be identical. An example could be: “Ms. X is a 78-year-old female with a past medical history of chronic obstructive pulmonary disease who presents with shortness of breath in the setting of an upper respiratory tract infection who is now stable on two liters of supplemental oxygen delivered via nasal cannula. Her symptoms are thought to be secondary to an acute exacerbation of chronic obstructive pulmonary disease.” • A differential diagnosis . For students, this should consist of 3-5 potential diagnoses. You should explain why you think each diagnosis is or is not the final diagnosis. Be sure to rule out potentially life-threatening conditions (unless you think your patient has one). For our fictional patient, Ms. X, for example, you could explain why you think she does not have a pulmonary embolism or acute coronary syndrome. For more advanced trainees, the differential can be more limited in scope. • Your plan . On regular inpatient floors, this should include a list of the patient’s medical problems, ordered by acuity, followed by your proposed plan for each. After going through each active medical problem, be sure to mention your choice for the patient’s diet and deep vein thrombosis prophylaxis, the patient’s stated code status, and the patient’s disposition (whether you think they need to remain in the hospital). In intensive care units, you can organize the patient’s medical problems by organ system to ensure that no stone is left unturned (if there are no active issues for an organ system, you may say so).

Presenting Patients Who Have Been in the Hospital for Multiple Days

After the initial presentation, subsequent presentations can be delivered via SOAP note format as follows:

• The  Subjective  section includes details about any significant overnight events and any new complaints the patient has.
• In the  Objective  section, report your physical exam (focus on any changes since you last examined the patient) and any significant new laboratory, imaging, or other diagnostic results.
• The  Assessment  and  Plan  are typically delivered as above. For the initial patient complaint, you do not have to restate your differential diagnosis if the diagnosis is known. For new complaints, however, you should create another differential and argue for or against each diagnosis. Be sure to update your plan every day.

Presenting Patients in Different Specialties

Before you present a patient, consider your audience. Every specialty presents patients differently. In general, surgical and OB/GYN presentations tend to be much quicker (2-3 minutes), while pediatric and family medicine presentations tend to be similar in length to internal medicine presentations. Tailor your presentations accordingly.

Presenting Patients in Outpatient Settings

Outpatients may be presented similarly to inpatients. Your presentation’s focus, however, should align with your outpatient clinic’s specialty. For example, if you are working at a cardiology clinic, your presentation should be focused on your patient’s cardiac complaints.

If your patient is returning for a follow-up visit and does not have a stated chief complaint, you should say so. You may replace the history of present illness with any relevant interval history since his or her last visit.

And that’s it! Delivering oral case presentations is challenging at first, so remember to practice. In time, you will become proficient in this essential medical skill. Good luck!

Kunal Sindhu, MD, is an assistant professor in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai and New York Proton Center. Dr. Sindhu specializes in treating cancers of the head, neck, and central nervous system.

2 thoughts on “How To Present a Patient: A Step-To-Step Guide”

To clarify, it should take 5-10 minutes to present (just one) new internal medicine inpatient? Or if the student had 4 patients to work up, it should take 10 minutes to present all 4 patients to the preceptor?

Good question. That’s per case, but with time you’ll become faster.

Comments are closed.

The Ultimate Patient Case Presentation Template for Med Students

• April 6, 2024
• Reviewed by: Amy Rontal, MD

Knowing how to deliver a patient presentation is one of the most important skills to learn on your journey to becoming a physician. After all, when you’re on a medical team, you’ll need to convey all the critical information about a patient in an organized manner without any gaps in knowledge transfer.

One big caveat: opinions about the correct way to present a patient are highly personal and everyone is slightly different. Additionally, there’s a lot of variation in presentations across specialties, and even for ICU vs floor patients.

My goal with this blog is to give you the most complete version of a patient presentation, so you can tailor your presentations to the preferences of your attending and team. So, think of what follows as a model for presenting any general patient.

Here’s a breakdown of what goes into the typical patient presentation.

Looking for some help studying your shelf/Step 2 studying with clinical rotations? Try our combined   Step 2 & Shelf Exams Qbank  with 5,500 practice questions— free for 7 days!

7 Ingredients for a Patient Case Presentation Template

1. the one-liner.

The one-liner is a succinct sentence that primes your listeners to the patient.

A typical format is: “[Patient name] is a [age] year-old [gender] with past medical history of [X] presenting with [Y].

2. The Chief Complaint

This is a very brief statement of the patient’s complaint in their own words. A common pitfall is when medical students say that the patient had a chief complaint of some medical condition (like cholecystitis) and the attending asks if the patient really used that word!

An example might be, “Patient has chief complaint of difficulty breathing while walking.”

3. History of Present Illness (HPI)

The goal of the HPI is to illustrate the story of the patient’s complaint. I remember when I first began medical school, I had a lot of trouble determining what was relevant and ended up giving a lot of extra details. Don’t worry if you have the same issue. With time, you’ll learn which details are important. 

The OPQRST Framework

In the beginning of your clinical experience, a helpful framework to use is OPQRST:

Describe when the issue started, and if it occurs during certain environmental or personal exposures.

P rovocative

Report if there are any factors that make the pain better or worse. These can be broad, like noting their shortness of breath worsened when lying flat, or their symptoms resolved during rest. 

Relay how the patient describes their pain or associated symptoms. For example, does the patient have a burning versus a pressure sensation? Are they feeling weakness, stiffness, or pain?

R egion/Location

Indicate where the pain is located and if it radiates anywhere.

Talk about how bad the pain is for the patient. Typically, a 0-10 pain scale is useful to provide some objective measure.

Discuss how long the pain lasts and how often it occurs.

A Case Study

While the OPQRST framework is great when starting out, it can be limiting. Let’s take an example where the patient is not experiencing pain and comes in with altered mental status along with diffuse jaundice of the skin and a history of chronic liver disease. You will find that certain sections of OPQRST do not apply. In this event, the HPI is still a story, but with a different framework. Try to go in chronological order. Include relevant details like if there have been any changes in medications, diet, or bowel movements.

Pertinent Positive and Negative Symptoms

Regardless of the framework you use, the name of the game is pertinent positive and negative symptoms the patient is experiencing. I’d like to highlight the word “pertinent.” It’s less likely the patient’s chronic osteoarthritis and its management is related to their new onset shortness of breath, but it’s still important for knowing the patient’s complete medical picture. A better place to mention these details would be in the “Past Medical History” section, and reserve the HPI portion for more pertinent history. As you become exposed to more illness scripts, experience will teach you which parts of the history are most helpful to state. Also, as you spend more time on the wards, you will pick up on which questions are relevant and important to ask during the patient interview.   By painting a clear picture with pertinent positives and negatives during your presentation, the history will guide what may be higher or lower on the differential diagnosis. Some other important components to add are the patient’s additional past medical/surgical history, family history, social history, medications, allergies, and immunizations.

The HEADSSS Method

Particularly, the social history is an important time to describe the patient as a complete person and understand how their life story may affect their present condition. One way of organizing the social history is the HEADSSS method: – H ome living situation and relationships – E ducation and employment – A ctivities and hobbies – D rug use (alcohol, tobacco, cocaine, etc.) Note frequency of use, and if applicable, be sure to add which types of alcohol consumption (like beer versus hard liquor) and forms of drug use. – S exual history (partners, STI history, pregnancy plans) – S uicidality and depression – S piritual and religious history   Again, there’s a lot of variation in presenting social history, so just follow the lead of your team. For example, it’s not always necessary/relevant to obtain a sexual history, so use your judgment of the situation.

4. Review of Symptoms

Oftentimes, most elements of this section are embedded within the HPI. If there are any additional symptoms not mentioned in the HPI, it’s appropriate to state them here.

5. Objective

Vital signs.

Some attendings love to hear all five vital signs: temperature, blood pressure (mean arterial pressure if applicable), heart rate, respiratory rate, and oxygen saturation. Others are happy with “afebrile and vital signs stable.” Just find out their preference and stick to that. 

Physical Exam  

This is one of the most important parts of the patient presentation for any specialty. It paints a picture of how the patient looks and can guide acute management like in the case of a rigid abdomen. As discussed in the HPI section, typically you should report pertinent positives and negatives. When you’re starting out, your attending and team may prefer for you to report all findings as part of your learning. For example, pulmonary exam findings can be reported as: “Regular chest appearance. No abnormalities on palpation. Lungs resonant to percussion. Clear to auscultation bilaterally without crackles, rhonchi, or wheezing.” Typically, you want to report the physical exams in a head to toe format: General Appearance, Mental Status, Neurologic, Eyes/Ears/Nose/Mouth/Neck, Cardiovascular, Pulmonary, Breast, Abdominal, Genitourinary, Musculoskeletal, and Skin. Depending on the situation, additional exams can be incorporated as applicable.

Now comes reporting pertinent positive and negative labs. Several labs are often drawn upon admission. It’s easy to fall into the trap of reading off all the labs and losing everyone’s attention. Here are some pieces of advice: 

You normally can’t go wrong sticking to abnormal lab values. 

One qualification is that for a patient with concern for acute coronary syndrome, reporting a normal troponin is essential. Also, stating the normalization of previously abnormal lab values like liver enzymes is important.

Demonstrate trends in lab values.

A lab value is just a single point in time and does not paint the full picture. For example, a hemoglobin of 10g/dL in a patient at 15g/dL the previous day is a lot more concerning than a patient who has been stable at 10g/dL for a week.

Try to avoid editorializing in this section.

Save your analysis of the labs for the assessment section. Again, this can be a point of personal preference. In my experience, the team typically wants the raw objective data in this section. This is also a good place to state the ins and outs of your patient (if applicable). In some patients, these metrics are strictly recorded and are typically reported as total fluid in and out over the past day followed by the net fluid balance. For example, “1L in, 2L out, net -1L over the past 24 hours.”

6. Diagnostics/Imaging

Next, you’ll want to review any important diagnostic tests and imaging. For example, describe how the EKG and echo look in a patient presenting with chest pain or the abdominal CT scan in a patient with right lower quadrant abdominal pain. Try to provide your own interpretation to develop your skills and then include the final impression. Also, report if a diagnostic test is still pending.

7. Assessment/Plan

This is the fun part where you get to use your critical thinking (aka doctor) skills! For the scope of this blog, we’ll review a problem-based plan. It’s helpful to begin with a summary statement that incorporates the one-liner, presenting issue(s)/diagnosis(es), and patient stability. Then, go through all the problems relevant to the admission. You can impress your audience by casting a wide differential diagnosis and going through the elements of your patient presentation that support one diagnosis over another.  Following your assessment, try to suggest a management plan. In a patient with congestive heart failure exacerbation, initiating a diuresis regimen and measuring strict ins/outs are good starting points. You may even suggest a follow-up on their latest ejection fraction with an echo and check if they’re on guideline-directed medical therapy. Again, with more time on the clinical wards you’ll start to pick up on what management plan to suggest. One pointer is to talk about all relevant problems, not just the presenting issue. For example, a patient with diabetes may need to be put on a sliding scale insulin regimen or another patient may require physical/occupational therapy. Just try to stay organized and be comprehensive.

A Note About Patient Presentation Skills

When you’re doing your first patient presentations, it’s common to feel nervous. There may be a lot of “uhs” and “ums.”

Here’s the good news: you don’t have to be perfect! You just need to make a good faith attempt and keep on going with the presentation.

With time, your confidence will build. Practice your fluency in the mirror when you have a chance. No one was born knowing medicine and everyone has gone through the same stages of learning you are!

Practice your presentation a couple times before you present to the team if you have time. Pull a resident aside if they have the bandwidth to make sure you have all the information you need. 

One big piece of advice: NEVER LIE. If you don’t know a specific detail, it’s okay to say, “I’m not sure, but I can look that up.” Someone on your team can usually retrieve the information while you continue on with your presentation.

Example Patient Case Presentation Template

Here’s a blank patient case presentation template that may come in handy. You can adapt it to best fit your needs.   One-Liner:   Chief Complaint:   History of Present Illness:   Past Medical History: Past Surgical History: Family History: Social History: Medications: Allergies: Immunizations:   ROS:   Objective:   Vital Signs : Temp ___ BP ___ /___ HR ___ RR ___ O2 sat ___   Physical Exam:

General Appearance:

Mental Status:

Neurological:

Eyes, Ears, Nose, Mouth, and Neck:

Cardiovascular:

Genitourinary:

Musculoskeletal:

Most Recent Labs:

Previous Labs:

Diagnostics/Imaging:

Impression/Interpretation:

Assessment/Plan:

One-line summary:

#Problem 1:

Assessment:

#Problem 2:

Final Thoughts on Patient Presentations

I hope this post demystified the patient presentation for you. Be sure to stay organized in your delivery and be flexible with the specifications your team may provide.   Something I’d like to highlight is that you may need to tailor the presentation to the specialty you’re on. For example, on OB/GYN, it’s important to include a pregnancy history. Nonetheless, the aforementioned template should set you up for success from a broad overview perspective.   Stay tuned for my next post on how to give an ICU patient presentation. And if you’d like me to address any other topics in a blog, write to me at [email protected] ! Looking for more (free!) content to help you through clinical rotations? Check out these other posts from Blueprint tutors on the Med School blog:

• How I Balanced My Clinical Rotations with Shelf Exam Studying
• How (and Why) to Use a Qbank to Prepare for USMLE Step 2
• How to Study For Shelf Exams: A Tutor’s Guide

About the Author

Hailing from Phoenix, AZ, Neelesh is an enthusiastic, cheerful, and patient tutor. He is a fourth year medical student at the Keck School of Medicine of the University of Southern California and serves as president for the Class of 2024. He is applying to surgery programs for residency. He also graduated as valedictorian of his high school and the USC Viterbi School of Engineering, obtaining a B.S. in Biomedical Engineering in 2020. He discovered his penchant for teaching when he began tutoring his friends for the SAT and ACT in the summer of 2015 out of his living room. Outside of the academic sphere, Neelesh enjoys surfing at San Onofre Beach and hiking in the Santa Monica Mountains. Twitter: @NeeleshBagrodia LinkedIn: http://www.linkedin.com/in/neelesh-bagrodia

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Presenting a Clinical Vignette: Deciding What to Present

If you are scheduled to make a presentation of a clinical vignette, reading this article will improve your performance. We describe a set of practical, proven steps that will guide your preparation of the presentation. The process of putting together a stellar presentation takes time and effort, and we assume that you will be willing to put forth the effort to make your presentation successful. This and subsequent articles will focus on planning, preparation, creating visual aids (slides), and presentation skills. The intent of this series of articles is to help you make a favorable impression and reap the rewards, personal and professional, of a job well done.

The process begins with the creation of an outline of the topics that might be presented at the meeting. Your outline should follow the typical format and sequence for this type of communication: history, physical examination, investigations, patient course, and discussion. This format is chosen because your audience understands it and uses it every day. If you have already prepared a paper for publication, it can be a rich source of content for the topic outline.

To get you started, we have prepared a generic outline to serve as an example. Look over the generic outline to get a sense of what might be addressed in your presentation. We realize that the generic outline will not precisely fit all of the types of cases; nevertheless, think about the larger principle and ask yourself, "How can I adapt this to my situation?" In order to help you visualize the type of content you might include in the outline, an example of a topic outline for a clinical vignette is presented.

Introduction

The main purpose of the introduction is to place the case in a clinical context and explain the importance or relevance of the case. Some case reports begin immediately with the description of the case, and this is perfectly acceptable.

1. Describing the clinical context and relevance

i. Ergotism is characterized by intense, generalized vasoconstriction of small and large blood vessels. ii. Ergotism is rare and therefore difficult to diagnose. iii. Failure to diagnose can lead to significant morbidity.

Case Presentation

The case report should be chronological and detail the history, physical findings, and investigations followed by the patient's course. At this point, you may wish to include more details than you might have time to present, prioritizing the content later.

i. A 34-year-old female smoker has chronic headaches, dyspnea, and burning leg pain. ii. Clinical diagnosis of mitral valve stenosis is made. iii. She returns in one week because of burning pain in the legs. iv. One month after presentation, cardiac catheterization demonstrates severe mitral valve stenosis. v. Elective mitral valve commisurotomy is scheduled, but the patient is admitted to hospital early because of increased burning pain in her feet and a painful right leg.

2. Physical Examination

i. Normal vital signs. ii. No skin findings. iii. Typical findings of mitral stenosis, no evidence of heart failure. iv. Cool, pulseless right leg. v. Normal neurological examination.

3. Investigations

i. Normal laboratory studies. ii. ECG shows left atrial enlargement. iii. Arteriogram of right femoral artery shows subtotal stenosis, collateral filling of the popliteal artery, and pseudoaneurysm formation.

4. Hospital Course

i. Mitral valve commisurotomy is performed, as well as femoral artery thombectomy, balloon dilation, and a patch graft repair. ii. On the fifth postoperative day, the patient experienced a return of burning pain in the right leg. The leg was pale, cool, mottled, and pulseless. iii. The arteriogram of femoral arteries showed smooth segmental narrowing and bilateral vasospasm suggesting large-vessel arteritis complicated by thrombosis. iv. Treatment was initiated with corticosteroids, anticoagulants, antiplatelet drugs, and oral vasodilators. v. The patient continued to deteriorate with both legs becoming cool and pulseless. vi. Additional history revealed that the patient abused ergotamine preparations for years (headaches). She used 12 tables daily for the past year and continued to receive ergotamine in hospital on days 2, 6, and 7. vii. Ergotamine preparations were stopped, intravenous nitroprusside was begun, and she showed clinical improvement within 2 hours. Nitroprusside was stopped after 24 hours, and the symptoms did not return. viii. The remainder of hospitalization was uneventful.

The main purpose of the discussion section is to articulate the lessons learned from the case. It should describe how a similar case should be approached in the future. It is sometimes appropriate to provide background information to understand the pathophysiological mechanisms associated with the patient's presentation, findings, investigations, course, or therapy.

1. Discussion

i. The most common cause of ergotism is chronic poisoning found in young females with chronic headaches. ii. Manifestations can include neurological, gastrointestinal, and vascular (list each in a table). iii. Ergotamine poisoning induces intense vasospasm, and venous thrombosis may occur from direct damage to the endothelium. iv. Vasospasm is due primarily to the direct vasoconstrictor effects on the vascular smooth muscle. v. Habitual use of ergotamine can lead to withdrawal headaches leading to a cycle of greater levels of ingestion. vi. In addition to stopping ergotamine, a direct vasodilator is usually prescribed. vii. Lesson 1: Physicians should be alert to the potential of ergotamine toxicity in young women with chronic headaches that present with neurological, gastrointestinal, or ischemic symptoms. viii. Lesson 2: The value of a complete history and checking the medication list.

Creating a topic outline will provide a list of all the topics you might possibly present at the meeting. Since you will have only ten minutes, you will prioritize the topics to determine what to keep and what to cut.

How do you decide what to cut? First, identify the basic information in the three major categories that you simply must present. This represents the "must-say" category. If you have done your job well, the content you have retained will answer the following questions:

What happened to the patient? What was the time course of these events? Why did management follow the lines that it did? What was learned?

After you have identified the "must-say" content, identify information that will help the audience better understand the case. Call this the "elaboration" category. Finally, identify the content that you think the audience would like to know, provided there is enough time, and identify this as the "nice-to-know" category.

Preparing a presentation is an iterative process. As you begin to "fit" your talk into the allotted time, certain content you originally thought of as "elaboration" may be dropped to the "nice-to-know" category due to time constraints. Use the following organizational scheme to efficiently prioritize your outline.

Prioritizing Topics in the Topic Outline

1. Use your completed topic outline.

2. Next to each entry in your outline, prioritize the importance of content.

3. Use the following code system to track your prioritization decisions:

A = Must-Say B = Elaboration C = Nice-to-Know

4. Remember, this is an iterative process; your decisions are not final.

5. Review the outline with your mentor or interested colleagues, and listen to their decisions.

Use the Preparing the Clinical Vignette Presentation Checklist to assist you in preparing the topic outline.

How to make an oral case presentation to healthcare colleagues

The content and delivery of a patient case for education and evidence-based care discussions in clinical practice.

BSIP SA / Alamy Stock Photo

A case presentation is a detailed narrative describing a specific problem experienced by one or more patients. Pharmacists usually focus on the medicines aspect , for example, where there is potential harm to a patient or proven benefit to the patient from medication, or where a medication error has occurred. Case presentations can be used as a pedagogical tool, as a method of appraising the presenter’s knowledge and as an opportunity for presenters to reflect on their clinical practice [1] .

The aim of an oral presentation is to disseminate information about a patient for the purpose of education, to update other members of the healthcare team on a patient’s progress, and to ensure the best, evidence-based care is being considered for their management.

Within a hospital, pharmacists are likely to present patients on a teaching or daily ward round or to a senior pharmacist or colleague for the purpose of asking advice on, for example, treatment options or complex drug-drug interactions, or for referral.

Content of a case presentation

As a general structure, an oral case presentation may be divided into three phases [2] :

• Reporting important patient information and clinical data;
• Analysing and synthesising identified issues (this is likely to include producing a list of these issues, generally termed a problem list);
• Managing the case by developing a therapeutic plan.

Specifically, the following information should be included [3] :

Patient and complaint details

Patient details: name, sex, age, ethnicity.

Presenting complaint: the reason the patient presented to the hospital (symptom/event).

History of presenting complaint: highlighting relevant events in chronological order, often presented as how many days ago they occurred. This should include prior admission to hospital for the same complaint.

Review of organ systems: listing positive or negative findings found from the doctor’s assessment that are relevant to the presenting complaint.

Past medical and surgical history

Social history: including occupation, exposures, smoking and alcohol history, and any recreational drug use.

Medication history, including any drug allergies: this should include any prescribed medicines, medicines purchased over-the-counter, any topical preparations used (including eye drops, nose drops, inhalers and nasal sprays) and any herbal or traditional remedies taken.

Sexual history: if this is relevant to the presenting complaint.

Details from a physical examination: this includes any relevant findings to the presenting complaint and should include relevant observations.

Laboratory investigation and imaging results: abnormal findings are presented.

Assessment: including differential diagnosis.

Plan: including any pharmaceutical care issues raised and how these should be resolved, ongoing management and discharge planning.

Any discrepancies between the current management of the patient’s conditions and evidence-based recommendations should be highlighted and reasons given for not adhering to evidence-based medicine ( see ‘Locating the evidence’ ).

Locating the evidence

The evidence base for the therapeutic options available should always be considered. There may be local guidance available within the hospital trust directing the management of the patient’s presenting condition. Pharmacists often contribute to the development of such guidelines, especially if medication is involved. If no local guidelines are available, the next step is to refer to national guidance. This is developed by a steering group of experts, for example, the British HIV Association or the National Institute for Health and Care Excellence . If the presenting condition is unusual or rare, for example, acute porphyria, and there are no local or national guidelines available, a literature search may help locate articles or case studies similar to the case.

Giving a case presentation

Currently, there are no available acknowledged guidelines or systematic descriptions of the structure, language and function of the oral case presentation [4] and therefore there is no standard on how the skills required to prepare or present a case are taught. Most individuals are introduced to this concept at undergraduate level and then build on their skills through practice-based learning.

A case presentation is a narrative of a patient’s care, so it is vital the presenter has familiarity with the patient, the case and its progression. The preparation for the presentation will depend on what information is to be included.

Generally, oral case presentations are brief and should be limited to 5–10 minutes. This may be extended if the case is being presented as part of an assessment compared with routine everyday working ( see ‘Case-based discussion’ ). The audience should be interested in what is being said so the presenter should maintain this engagement through eye contact, clear speech and enthusiasm for the case.

It is important to stick to the facts by presenting the case as a factual timeline and not describing how things should have happened instead. Importantly, the case should always be concluded and should include an outcome of the patient’s care [5] .

An example of an oral case presentation, given by a pharmacist to a doctor,  is available here .

A successful oral case presentation allows the audience to garner the right amount of patient information in the most efficient way, enabling a clinically appropriate plan to be developed. The challenge lies with the fact that the content and delivery of this will vary depending on the service, and clinical and audience setting [3] . A practitioner with less experience may find understanding the balance between sufficient information and efficiency of communication difficult, but regular use of the oral case presentation tool will improve this skill.

Tailoring case presentations to your audience

Most case presentations are not tailored to a specific audience because the same type of information will usually need to be conveyed in each case.

However, case presentations can be adapted to meet the identified learning needs of the target audience, if required for training purposes. This method involves varying the content of the presentation or choosing specific cases to present that will help achieve a set of objectives [6] . For example, if a requirement to learn about the management of acute myocardial infarction has been identified by the target audience, then the presenter may identify a case from the cardiology ward to present to the group, as opposed to presenting a patient reviewed by that person during their normal working practice.

Alternatively, a presenter could focus on a particular condition within a case, which will dictate what information is included. For example, if a case on asthma is being presented, the focus may be on recent use of bronchodilator therapy, respiratory function tests (including peak expiratory flow rate), symptoms related to exacerbation of airways disease, anxiety levels, ability to talk in full sentences, triggers to worsening of symptoms, and recent exposure to allergens. These may not be considered relevant if presenting the case on an unrelated condition that the same patient has, for example, if this patient was admitted with a hip fracture and their asthma was well controlled.

Case-based discussion

The oral case presentation may also act as the basis of workplace-based assessment in the form of a case-based discussion. In the UK, this forms part of many healthcare professional bodies’ assessment of clinical practice, for example, medical professional colleges.

For pharmacists, a case-based discussion forms part of the Royal Pharmaceutical Society (RPS) Foundation and Advanced Practice assessments . Mastery of the oral case presentation skill could provide useful preparation for this assessment process.

A case-based discussion would include a pharmaceutical needs assessment, which involves identifying and prioritising pharmaceutical problems for a particular patient. Evidence-based guidelines relevant to the specific medical condition should be used to make treatment recommendations, and a plan to monitor the patient once therapy has started should be developed. Professionalism is an important aspect of case-based discussion — issues must be prioritised appropriately and ethical and legal frameworks must be referred to [7] . A case-based discussion would include broadly similar content to the oral case presentation, but would involve further questioning of the presenter by the assessor to determine the extent of the presenter’s knowledge of the specific case, condition and therapeutic strategies. The criteria used for assessment would depend on the level of practice of the presenter but, for pharmacists, this may include assessment against the RPS  Foundation or Pharmacy Frameworks .

Acknowledgement

With thanks to Aamer Safdar for providing the script for the audio case presentation.

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Your CPD module results are stored against your account here at The Pharmaceutical Journal . You must be registered and logged into the site to do this. To review your module results, go to the ‘My Account’ tab and then ‘My CPD’.

Any training, learning or development activities that you undertake for CPD can also be recorded as evidence as part of your RPS Faculty practice-based portfolio when preparing for Faculty membership. To start your RPS Faculty journey today, access the portfolio and tools at www.rpharms.com/Faculty

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[1] Onishi H. The role of case presentation for teaching and learning activities. Kaohsiung J Med Sci 2008;24:356–360. doi: 10.1016/s1607-551x(08)70132–3

[2] Edwards JC, Brannan JR, Burgess L et al . Case presentation format and clinical reasoning: a strategy for teaching medical students. Medical Teacher 1987;9:285–292. doi: 10.3109/01421598709034790

[3] Goldberg C. A practical guide to clinical medicine: overview and general information about oral presentation. 2009. University of California, San Diego. Available from: https://meded.ecsd.edu/clinicalmed.oral.htm (accessed 5 December 2015)

[4] Chan MY. The oral case presentation: toward a performance-based rhetorical model for teaching and learning. Medical Education Online 2015;20. doi: 10.3402/meo.v20.28565

[5] McGee S. Medicine student programs: oral presentation guidelines. Learning & Scholarly Technologies, University of Washington. Available from: https://catalyst.uw.edu/workspace/medsp/30311/202905 (accessed 7 December 2015)

[6] Hays R. Teaching and Learning in Clinical Settings. 2006;425. Oxford: Radcliffe Publishing Ltd.

[7] Royal Pharmaceutical Society. Tips for assessors for completing case-based discussions. 2015. Available from: http://www.rpharms.com/help/case_based_discussion.htm (accessed 30 December 2015)

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How to write a medical case report

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• Seema Biswas , editor-in-chief, BMJ Case Reports, London, UK ,
• Oliver Jones , student editor, BMJ Case Reports, London, UK

Two BMJ Case Reports journal editors take you through the process

This article contains...

- Choosing the right patient

- Choosing the right message

- Before you begin - patient consent

- How to write your case report

- How to get published

During medical school, students often come across patients with a unique presentation, an unfamiliar response to treatment, or even an obscure disease. Writing a case report is an excellent way of documenting these findings for the wider medical community—sharing new knowledge that will lead to better and safer patient care.

For many medical students and junior doctors, a case report may be their first attempt at medical writing. A published case report will look impressive on your curriculum vitae, particularly if it is on a topic of your chosen specialty. Publication will be an advantage when applying for foundation year posts and specialty training, and many job applications have points allocated exclusively for publications in peer reviewed journals, including case reports.

The writing of a case report rests on skills that medical students acquire in their medical training, which they use throughout their postgraduate careers: these include history taking, interpretation of clinical signs and symptoms, interpretation of laboratory and imaging results, researching disease aetiology, reviewing medical evidence, and writing in a manner that clearly and effectively communicates with the reader.

If you are considering writing a case report, try to find a senior doctor who can be a supervising coauthor and help you decide whether you have a message worth writing about, that you have chosen the correct journal to submit to (considering the format that the journal requires), that the process is transparent and ethical at all times, and that your patient is not compromised in your writing. Indeed, try to include your patient in the process from the …

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Clinical Case Study Presentation Template

Number of slides: 10

A clinical case study is a report where medical practitioners share a patient’s case. Generally, clinical case studies are valuable tools for medical research as they provide detailed information on the development of a disease or illness in particular individuals. Use this PowerPoint template to document extraordinary patient cases and share your findings with the healthcare community. You can also use these slides to report the progress of your patient’s disease and work on the proper treatment alongside your team.

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Free Template for presenting a Clinical Case Study in PowerPoint

Patient’s clinical profile.

Before starting, share the patient’s clinical profile. This slide is great to describe your patient’s clinical history, underlying conditions, and other relevant health information. You can include demographic data and specific facts related to your patient but remember to keep their anonymity.

Clinical Treatment Slide

This is one of the most important sections of your patient’s case study. You’ll find a creative slide to explain the medical treatment stage by stage. You can go deep into the medicines or drugs the patient used and their reaction in different stages of the treatment. This means you’ll be able to cover the evolution of your patient from the beginning and provide detailed insights. 

Medical Team Slide

As in any research, you should acknowledge the professionals that worked with you. So, here’s a slide to showcase the whole medical team involved in the case study. You can add photos and short descriptions of each team member. Make sure to ask for professional images and double-check the spelling of role titles and names.   

Roadmaps for Clinical Case Study Presentations

If you’re wondering how to present a patient case study in PowerPoint, the best way to do so is by taking full advantage of its visual elements. Here you’ll find creative roadmaps, diagrams, and icons

Medical PowerPoint Slides

The Clinical Case Study PowerPoint template has a clean and minimalistic style that makes your work stand out in high-level professional slides.

Medical icons in PowerPoint

You’ll find medical icons on every PowerPoint slide. Use them to organize your information and direct your audience’s attention exactly where you want it to be.

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How to Develop an Amazing Healthcare Simulation Presentation

Erin Carn Bennett

Erin Carn-Bennett is a Simulation Nurse Educator for the Douglas Starship Simulation Programme in Auckland, New Zealand. Carn-Bennett has her Masters of Nursing and has an extensive nursing career within pediatric emergency and also nursing management. She is passionate about debriefing and all things simulation. Carn-Bennett is a member of the IPSS board of directors. Carn-Bennett is the lead host of the podcast Sim Nurse NZ.

An effective verbal presentation with an impressive slide deck which is presented to a high standard is not easily obtained without experience, practice and consideration. As healthcare staff that work in healthcare simulation , presentation skills are often expected as part of the role as a clinical educator. However, there is often no formal education provided to staff and skill acquisition occurs on the job. This article by Erin Carn-Bennett, RN, MSN will explore tips to create a highly effective slide deck for presentation and also presentation skills that can take the healthcare simulation didactic presentation to the next level.

Introductions in a Clinical Simulation Presentation are Critical to Gain Interest

Be sure to introduce the speaker and focus upon any relevant clinical experiences and also healthcare simulation experiences. This will assist to build trust and psychological safety with participants. Introductions at healthcare simulation courses are incredibly important to set the scene and the tone of the course. An introduction segment on a healthcare simulation course which is rushed and unconsidered shows. Don’t be in a rush in the initial phase of a verbal presentation for a clinical simulation course.

Have a clear structure which is explained at the start of the introductions phase of the presentation. The structure of the presentation should explain what to expect in the time which will be spent in the verbal presentation. Adult learners will want to know briefly at the least of what to expect to learn within the presentation time. This will assist the adult learner with motivation and engagement for the topic which is being presented.

The Use of Appropriate Stories is a Key Strategy to Hold Engagement

As a presenter, the use of stories that are effective and also relevant to healthcare simulation within the verbal presentation should be encouraged and also capitalized on. As a presenter read the room through interest demonstrated with body language and take a lot of consideration as to what stories are chosen to be shared. Be sure to de-identify any identifiable features of the stories which are shared in the presentation in order to protect any staff or patients involved. Confidentiality should always be maintained and the learner or those involved in the story should be represented in the story in a respectful manner with psychological safety at the forefront for all involved.

Use pictures and photos of clinical simulation as much as possible in the presentation to demonstrate relevant practices. Ensure that the appropriate permissions and consents are gained for use relevant to the organization . Pictures in the presentation can assist to hold concentration and engagement of the adult learner. Slides should not have too many words on them. Don’t read what is written off the slide deck. The words on the slide should contain key words; but the presenter should present the learning objectives, story and content that relates to the slide.

Slide Decks are a Constant Work in Progress for Presenters

Slide decks for verbal presentations on healthcare simulation courses should be in a constant revision and edit process. After revision post a clinical simulation course; be sure to update the slide deck and add any improvements or remove content no longer required. This process can be informed by clinical simulation participants, the speaker and other faculty staff involved in the course delivery.

If there is the use of sounds or videos on certain slides be sure to allow time prior to presentation to check that sound and video works on the slidedeck. Have technology support available just in case so troubleshooting this in the moment doesn’t add more stress prior to the presentation. As a presenter tensions can be high prior to delivery; adequate team support from trusted colleagues can assist greatly to alleviate stress levels.

Duplicate slides while in the creation phase of slide decks to save time. Add any relevant organizational logos that have supported the course to the bottom of slides so that these are present prior to the slides being duplicated. Toy with the addition of animations to slide decks but be comfortable and practice with them prior to presentation.

View the HealthySimulation.com LEARN CE/CME Platform Webinar Clinical Simulation Professional Development: A Scaffold Approach to learn more!

Have Adequate Team Support on the Presentation Day if Possible

Find out if there will be the use of a clicker in the presentation on the day for the presenter on the clinical simulation course. This can add to ease of presentation and can mean that the presenter can be more easily mobile around the room to engage more with clinical simulation participants. Keep the healthcare simulation participants busy. Have them up and moving at intervals where possible to maintain connection and interest. Allow questions, conversation and story sharing. Get the balance of didactic presentation to clinical simulation scenarios right. This can be harder than anticipated.

Use an appropriate font size on the slide decks to ensure the majority of the clinical simulation participants will be able to see the content easily. Without this consideration, participants will strain to read the words on the screen and disengage from listening to the presenter. Link any learnings throughout the presentation to any stories or points shared by participants to re-emphasize key take homes. Use body language to display and exude confidence as a presenter even if not feeling confident. These may include power poses, open stance and eye contact.

Make time for lots of practice time for delivery of the presentation. The presenter should aim to be authentic and their true self; demonstrating their own unique point of view. Be sure to watch videos online of highly experienced public speakers who share tips about how to public speak. For example: This video by Mel Robbins (the number one female empowerment speaker in the world) shares incredibly effective and easy skills to use in presentations for clinical simulation talks in the healthcare workplace.

This article has discussed both how to create and also how to deliver an amazing presentation for a clinical simulation course. The creation and review of a slide deck for a clinical simulation course is not an easy process without previous experience. However, skills in this area build quickly with practice and careful consideration. This article discusses a number of simple strategies of how to undertake this process and how to deliver a high level presentation for a clinical simulation course. Although for many clinical simulation staff verbal presentation skills take time to accumulate; the time is now to acquire and also improve on these critical skills as an educator in healthcare simulation.

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Clinical mental health counseling: trauma studies specialization.

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Promote healing in survivors of trauma.

Trauma affects the mind, the body, and the spirit. Without intervention, these effects can last a lifetime. Develop the skills and knowledge needed to foster healing in people across the lifespan. Through Lesley's Trauma Studies master's degree program, you can choose to pursue one or two internships where you'll gain 700 to 1,300 hours of clinical experience while training alongside practitioners who are driving new thinking in the field.

Advances in neurobiology and increased public awareness have turned a spotlight on the profound biopsychosocial consequences of traumatic experiences on the lives of people. At the same time, growing numbers of those in need of such services, including military veterans, international refugees, and domestic violence survivors, are unable to access the services they need.

At Lesley, our faculty practitioners work alongside you to address these urgent challenges so you can help people sustain hope and break out of unconstructive behaviors and patterns.

You’ll explore the emerging field of post-traumatic therapy, with a focus on counseling those with Post-Traumatic Stress Disorder. Discover culturally appropriate community and crisis interventions that foster resilience in the aftermath of violence. And investigate how art and play therapy can facilitate change in children and adolescents.

By completing clinical internships at one or two of Lesley’s 400+ approve sites throughout Greater Boston and across New England, you’ll have all the experience and expertise you need to apply to for your Licensed Mental Health Counselor (LMHC) credential.

Program Structure

On-Campus Full- or Part-Time Program

• Required courses in developmental psychology, counseling and psychotherapy theory, clinical skills, research methods, and more.
• Required specialization courses in psychological trauma and post-trauma therapy, disaster mental heath and community crisis intervention, and trauma in the lives of children and adolescents and play therapy
• Students who choose the one-internship option will earn 6 credits through supervision courses that accompany their internship. Students who choose the two-internship option will earn 12 credits through supervision courses that accompany their internships.
• Students who choose the one-internship option will have 9 elective credits to take. Students who choose the two-internship option will have 3 elective credits to take.
• Through our clinical mental health counseling program, gain eligibility for Licensed Mental Health Counselor (LMHC) credential in Massachusetts
• Full-time example: 6-11 credits/semester for 7 semesters, including summer. Complete in just under 3 years. Part-time examples: 5-7 credits/semester for 10 semesters, including summer. Complete in about 3.5 years.

Have questions about the clinical mental health counseling master's program? View our frequently asked questions to find your answer.

• When do the master’s degree programs enroll? The master’s degree programs enroll in the Fall and in the Spring. However, once in the program, students take courses during the Fall, Spring, and Summer semesters.
• What is the application deadline for the master’s degree programs? The master’s degree programs have two application deadlines. The application deadline to start in the fall semester is on May 1. The application deadline to start in the spring semester is on November 1.
• Do I need to have an undergraduate degree in psychology in order to apply for these master’s degree programs? No! All applicants are required to have a bachelor’s degree, but it does not have to be in psychology, counseling, or a related area of study.
• Does the program have online courses? No. All graduate programs within the Division of Counseling & Psychology are on-campus here in Cambridge, MA. The Division does not offer online programs at this time.
• Can I take courses part-time? Yes! Part-time students will take one or two courses (3 or 6 credits) per semester. Full-time students will take three courses (9 credits) per semester.
• When are courses offered? Courses within the Division of Counseling & Psychology are all on-campus and offered in two different formats: weekday and weekend formats. Course format offerings/availability are subject to a variety of factors and can change from semester to semester. Some classes may be offered in both the weekday and weekend model, and in that case, you could choose which format you prefer. However, other courses may only be offered in one format for a given semester. Formats include weekdays, in which you will have class once a week for 2.5 hours for each class in which you are enrolled. Classes are usually offered from 1-3:30pm, 4-6:30pm, and 7-9:30pm. The second is a weekend format in which you will be on campus for only two weekends, with four weeks in between the two weekends for each class in which you are enrolled. Those two weekends consist of classes on Friday evening from 5-9:50pm, Saturday from 9-6pm, and Sunday 9-6pm. With the weekend format, you are only required to come to campus twice each semester for each class. Please note that it is not possible to complete the entire program in just the weekend model.

The Division of Counseling & Psychology does not currently allow class visits due to the sensitive nature of topics that can arise during class discussion. This is in an effort to make sure that classes are always safe spaces for the current students. We encourage you to schedule a tour of Lesley’s campus or request to speak with a current student.  Sign up for a campus tour hosted by a current graduate student.

This program is designed to prepare graduates to pursue their license as a Mental Health Counselor, School Counselor, of School Adjustment Counselor in the state of Massachusetts, depending on the program you complete. We strongly encourage prospective applicants who intend to pursue licensure or credentialing to  review our “Licensure and Credentialing Information for Prospective Applicants” document  prior to applying to our program.

Yes! There are two courses within the Division of Counseling & Psychology that are open to non-matriculated students. Your ability to enroll in the course will depend on if there is room in the course once fully matriculated students are registered. If you are interested in taking a course within the Division, please email Courtney Millette at  [email protected] .

One-Internship Option

The one-internship option is the most flexible way to complete your 60-credit master’s degree program in Clinical Mental Health Counseling with a specialization in Trauma Studies or Holistic Studies. If you choose to do one internship, over 2 semesters, you’ll engage in 700 hours of supervised internship/field experience in a clinical setting. You’ll earn 6 graduate credits through the supervision courses you take while completing your internship and you will meet the minimum requirements for licensure in Massachusetts. Because you’ll be doing one internship, you’ll have 9 credits to take in electives.

Two-Internship Option

You might choose the two-internship option to gain experience in an organization that will only accept students who already have internship experience in a clinical setting, or if you want to gain experience in a variety of settings. Over 4 semesters, you’ll engage in 1,300 hours of supervised internships/field experiences in clinical or school settings. You’ll earn 12 graduate credits through the supervision courses you take while completing your internships and you'll exceed the minimum requirements for licensure in Massachusetts. Because you’ll be doing an additional internship, you'll take 3 credits in electives.

Expected Program Competencies and Outcomes

Learn more about the expected competencies and outcomes that our clinical mental health counseling programs meet:

Outcome 1: Professional counselor identity development integrating multicultural awareness, culturally competent counseling, and social justice advocacy interventions

Outcome 2: Capacity for empathic engagement, therapeutic alliance, and critical self-reflection as a counselor including the recognition of personal worldview and biases to enhance working with diverse groups in school and community settings

Outcome 3: Knowledge of cognitive, social, and emotional development across the lifespan including ecological, contextual, multicultural, and social justice foundations

Outcome 4: Understanding of a variety of counseling theories, prevention, intervention, consultation, and social justice advocacy strategies

Outcome 5: Knowledge of individual psychopathology, mental health assessment and diagnosis, as defined by classification systems such as Diagnostic Statistical Manual (DSM) and the International Classification of Disease (ICD) and their relationship to treatment, prevention and knowledge of cultural biases associated with these systems

Outcome 6: Ability to conduct an intake interview, use biopsychosocial case conceptualization for treatment planning, and conceptualize and deliver a case presentation in both written and oral form  

Outcome 7: Knowledge regarding the use, limitations and interpretation of assessment tools with an awareness of the cultural bias in assessment protocols and use of assessment/evaluation instruments and techniques that foster social justice among diverse client populations

Outcome 8: Skills for training, consulting, and collaborating with families, school personnel, and healthcare providers for education, systems change, and social justice advocacy

Outcome 9: Understanding of ethical and legal professional standards of care grounded in federal and state laws, public policy processes, and ethical standards of ACA, AMHCA and ASCA

Outcome 10: Knowledge of principles and practices of career counseling including the study of vocational/career development theories and decision making models; career assessment instruments and techniques, and the application of social justice theories to people’s vocational/career development

Outcome 11: Understanding of how to critically evaluate and interpret traditional and social justice oriented research and apply relevant research in counseling practice with the knowledge of cultural biases associated with research practice

Outcome 12: Knowledge of group theory, effective group interventions, principles of group dynamics, group processes, and group leadership, and the application of group work theory and practice to organizational dynamics and social justice advocacy in difficult settings

Outcome 13: Neuroscience, physical and biological foundations of human development, behavior and wellness; including the use of neuro-scientific research findings for culturally competent counseling practices and social justice advocacy interventions

Outcome 14: Completion of supervised field placement experiences that focus on the promotion of mental health, human development, wellness, cultural competency, and social justice advocacy, under the clinical supervision of appropriately credentialed professionals

Cambridge, MA

A nexus for higher education and mental health counseling practice and research, each year 250,000 students arrive to Cambridge from around the globe. The intellectual and cultural capital runs deep, and so do your opportunities addressing barriers to wellness. From Lesley’s location, access innovative community, hospital, and school-based mental health programs.

• Inpatient psychiatric units
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• Homeless shelters
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Depending on your professional goals, where you reside or plan to practice, and the licensure requirements within that state, there are different pathways toward licensure or credentialing that may be relevant. In accordance with Lesley University’s institutional participation in SARA (State Authorization Reciprocity Agreement) and with federal regulations, we strongly encourage prospective applicants who intend to pursue licensure in a state other than Massachusetts to visit the Lesley University Licensure and Credentialing webpage and review the “Licensure Information for Students and Applicants” document for their specific program.

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Adam Meiselman

Assistant Professor of Counseling and Psychology

Sue Motulsky

Professor of Counseling and Psychology

Sue’s teaching, writing, and research interests are in developmental and relational psychology, including adult development, cultural psychology, gender issues and women’s psychology, identity and relational development, LGBTQ+ career and identity development, and career counseling and vocational development.

Research interests include feminist, relational psychology, identity development, career development and life/career transitions, specifically transgender and nonbinary adults’ career decision-making, and qualitative, constructivist and narrative research.

Joe Mageary

Associate Provost, Mental Health & Wellbeing

Joe Mageary, PhD, LMHC, CCMHC (he/him) is an Associate Professor in Lesley University’s Department of Counseling and Psychology. As a member of the core faculty, Dr. Mageary has also served as the Director of Field Training for Counseling and Psychology. He is a Massachusetts Licensed School Adjustment Counselor and Licensed Mental Health Counselor (LMHC), as well as a nationally certified Clinical Mental Health Counselor (CCMHC) and a Licensed Professional Counselor (LPC) in the state of Connecticut. He has used his LMHC in inpatient, outpatient, and community-based clinical roles and has extensive experience as a clinical supervisor, having worked as the Director of Emergency Services and Jail Diversion for an eighteen-town catchment area as well as serving as a Clinical Director in therapeutic high school settings for nearly a decade prior to joining Lesley’s faculty.

Throughout his career, Dr Mageary’s clinical work has been rooted in trauma-informed efforts to decrease stigma and suffering associated with mental illness through providing creative, community-based, collaborative, and recovery-oriented services. His clinical approach is influenced by tenets of Narrative Therapy, trauma-informed approaches, critical psychology, and brief therapies as well as by transdisciplinary thinkers such as Gregory Bateson and Edgar Morin. He holds a certificate from the Harvard Program in Refugee Trauma’s Global Mental Health: Trauma and Recovery program and is working interdisciplinarily on multiple projects related to supporting people who have been displaced and/or otherwise impacted by war, natural disaster, and other systemic stresses. Specifically, Dr. Mageary has worked with  Voces Arts and Healing , a group of expressive therapists, clinicians and advocates supporting asylum seekers and their allies in the Juarez, Mexico/El Paso, Texas metropolitan area. He is also actively partnered with the  Lesley University Institute for Trauma Sensitivity  (LIFTS) in weekly consultation and support for teachers and child psychologists in the Kirovohradska region of Ukraine.

Dr. Mageary is interested in exploring creative and body-oriented approaches to healing. He led a team that developed the Visual Reflection Team model: an arts-based version of the Reflecting Team technique used in Family Systems- and Narrative therapies.

In addition to having his LMHC, Dr. Joe Mageary is a:

• Nationally Certified Clinical Mental Health Counselor (CCMHC)
• Licensed School Adjustment Counselor and Special Education Administrator in the state of Massachusetts
• Level one- and two-trained Eye Movement Desensitization and Reprocessing (EMDR) clinician
• Member of the American Counseling Association (Massachusetts and Rhode Island Association for Counselor Education and Supervision Division) and the Massachusetts Mental Health Counselors Association

Rakhshanda Saleem

Professor, Counseling and Psychology

Rakhshanda’s scholarship and pedagogy is informed by a transnational and interdisciplinary perspective with a focus on the impact of structural and systemic violence. Her philosophical frameworks are embedded in decolonial, liberatory, and the emancipatory consciousness and the potential of grassroots and community-engaged movements. She is invested in solidarity organizing aimed at dismantling oppressive sociopolitical structural determinants of harm to individual and communal wellbeing and radical reimagining of alternatives to neoliberal and depoliticized theoretical models and wellness industry.  

Examples of her most recent scholarship include understanding issues facing disenfranchised migrant communities and learning about solidarity from the perspectives of impacted community members, activist, and organizers, exploring structural violence and its impact on “undocumented” Latinos (as) immigrants, Muslims (immigrants and non-immigrants), and LGBTQIA+ persons who have experienced incarceration, and identifying pre and post migration factors impacting the wellbeing of South Asian immigrant women.  Another area of interest and a developing project is exploring the trajectory of individuals involved in grassroot movements and community organizing in solidarity and resistance to systemic and structural violence to further understand consciousness raising and change occurs at an individual level.  

Rakhshanda is a licensed psychologist and a clinical neuropsychologist. Her work as a Harvard Medical School clinical instructor included assessment and clinical care for patients with diverse ethnic and cultural backgrounds needing linguistic and culture specific assessment and care.

Donna San Antonio

Donna Marie San Antonio has worked as a community organizer, teacher in grades 7-12, school counselor, outdoor educator-counselor, nonprofit administrator, and university instructor. She came to Lesley University in 2011 after teaching for 8 years in the Risk and Prevention Program at the Harvard Graduate School of Education. For 26 years, she directed the Appalachian Mountain Teen Project, an activity-based counseling program that she founded in 1984 to serve low-income and struggling youth in central and northern New Hampshire. 

Dr. San Antonio’s research and practice focus on understanding and supporting social, emotional, and physical wellness during adolescence and emerging adulthood. She has published on topics including developmental transitions for rural adolescents and emerging adults; the influence of social class and trauma in life course design and aspiration; experiential education/adventure-based counseling; school-based and workplace mentoring; school climate and social-emotional development; cross-role and cross-institutional collaboration; and community and school-based participatory action research for social change. Her current research projects include an exploration into the lifelong impact of therapeutic adventure activities during adolescence, and an auto-ethnography on how schools and communities in low-income rural areas support the social integration and well-being of migrant youth and families.  

Dr. San Antonio collaborates with international practitioners and researchers on urgent issues in school and community counseling. She frequently consults with school and community programs seeking to address cultural and economic barriers to success. She serves on the Editorial Board of the Journal of Experiential Education and is a Founding Member of the International Society of Policy, Research and Evaluation in School Counseling. She coordinates Lesley University’s affiliation with the UNESCO-UNITWIN Project on Lifelong Career. 

About her on-going community work, Dr. San Antonio says, "I believe in involving youth as active participants in addressing issues that threaten their well-being, such as poverty, racism, trauma, sexism, and homophobia.” As a classroom instructor and community activist, Dr. San Antonio works to create contexts that offer a high level of active critical reflection and dialogue. She enjoys hiking, biking, canoeing, cross-country skiing, and snowshoeing.   

Elizabeth Barragato

Visiting Instructor, Counseling & Psychology

Liz Barragato , MA, LMHC, has been an adjunct faculty member at Lesley University since 2014 and is thrilled to be a member of the core faculty starting in the 2021-2022 academic year. Liz has a private counseling and consultation practice in Cambridge, MA, and Liz is also a managing co-owner of Crooked Tree Counseling, LLC , in Cambridge.

Being a masters-level instructor, instead of having areas of scholarship, Liz had areas of clinical interest. Liz is interested in holistic theories and counseling methods, with a special interest in the intersection of Eastern wisdom practices, mental health, and wellness.

Liz brings this interest to the coordination of the Holistic Studies Specialization in the Counseling and Psychology Department. Liz is also deeply influenced by existential and relational psychoanalytic counseling approaches. Through all of these theoretical lenses, Liz see critical theory and issues of social justice permeating the work of counseling and teaching.

• On-Campus, One-Internship Option
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• Tuition $1,350 x 60 $81,000
• Fees Field Experience Fees $1,700 MAP Tevera Fee $200 Comprehensive Fee $1,500

All graduate students are reviewed for merit scholarships through the admissions process and are awarded at the time of acceptance. Other forms of financial aid are also available. Review all graduate tuition and fees , and what they cover. Tuition and fees are subject to change each year, effective in the Summer term.

• Tuition $1,350/credit x 60 $81,000
• Fees Field Experience Fees $3,400 MAP Tevera Fee $200 Comprehensive Fee $1,500

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The role of behavioral management in enhancing clinical care and efficiency, minimizing social disruption, and promoting welfare in captive primates.

Simple Summary

1. introduction, 2. materials and methods, 2.1. animal subjects, 2.2. behavioral management program, 2.3. iv access for blood sampling and animal monitoring, 2.4. statistical analysis, 3.1. behavioral management impact on intervention duration, 3.2. behavioral management impact on medical intervention and recovery (total duration), 3.3. side effects, 3.4. programmatic impact and total animal burden, 3.5. application of behavioral management for veterinary care—case studies, 3.5.1. case 1—wound management, 3.5.2. case 2—arthritis, 3.5.3. case 3—acute and supportive care, 4. discussion, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

• Parker, J.C.; Smarr, K.L.; Buckelew, S.P.; Stucky-ropp, R.C.; Hewett, J.E.; Johnson, J.C.; Wright, G.E.; Irvin, W.S.; Walker, S.E. Effects of stress management on clinical outcomes in rheumatoid arthritis. Arthritis Rheum. 1995 , 38 , 1807–1818. [ Google Scholar ] [ CrossRef ] [ PubMed ]
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Share and Cite

Oppler, S.H.; Palmer, S.D.; Phu, S.N.; Graham, M.L. The Role of Behavioral Management in Enhancing Clinical Care and Efficiency, Minimizing Social Disruption, and Promoting Welfare in Captive Primates. Vet. Sci. 2024 , 11 , 401. https://doi.org/10.3390/vetsci11090401

Oppler SH, Palmer SD, Phu SN, Graham ML. The Role of Behavioral Management in Enhancing Clinical Care and Efficiency, Minimizing Social Disruption, and Promoting Welfare in Captive Primates. Veterinary Sciences . 2024; 11(9):401. https://doi.org/10.3390/vetsci11090401

Oppler, Scott H., Sierra D. Palmer, Sydney N. Phu, and Melanie L. Graham. 2024. "The Role of Behavioral Management in Enhancing Clinical Care and Efficiency, Minimizing Social Disruption, and Promoting Welfare in Captive Primates" Veterinary Sciences 11, no. 9: 401. https://doi.org/10.3390/vetsci11090401

Business & regional news

Medtronic to present new data regarding use of the minimed™ 780g system among broader population at the european association for the study of diabetes (easd) 60th annual meeting.

The company will present clinical evidence in young children, pregnancy and type 2 diabetes*

Medtronic plc , the global leader in medical technology, announced it will present new data on its MiniMed™ 780G system at the upcoming European Association for the Study of Diabetes (EASD) 60th Annual Meeting in Madrid on September 9-13. The new clinical evidence on the MiniMed ™ 780G system will include areas where the company intends to work with global regulators towards expanding access to its diabetes technology including a lower age for those with type 1 diabetes, and type 2 diabetes.

Today the MiniMed 780G™ system is approved for use in individuals aged 7 years and above with type 1 diabetes. Maintaining stable blood glucose levels is critical for the physical and cognitive development of very young children. By automating insulin delivery, the burden of diabetes on family life, especially during the night, can also be improved.

For women with type 1 diabetes, the challenges to achieving the necessary level of glycemic control in pregnancy to avoid risks to both the mother and the baby extend to delivery and the post-partum period. Pregnant women with type 1 diabetes are advised to aim for tighter control of their glucose levels, typically targeting a range of 63-140 mg/dL (3.5-7.8 mmol/L) 1-3 , to minimize the risk of high blood sugar levels, which can have adverse effects on the baby's development.

Data will also highlight the ability of the system to reduce burden at mealtimes for people living with diabetes and more real-world evidence demonstrating the ability of the MiniMed 780G™ system to help users achieve their glycemic goals.

SCIENTIFIC DATA The following poster and oral scientific data presentations represent the work of Medtronic employees and independent investigators using Medtronic devices in their research.

• “The LENNY randomized crossover trial demonstrates the MiniMed™ 780G system is safe and effective for children aged 2-6” –oral presentation (LBA OP O2) by Prof. Tadej Battelino, MD, Head of Department of Pediatric and Adolescent Endocrinology, UMC Ljubljana, Slovenia on Friday, September 13 at 12:15 CEST (Venue: Cairo Hall)  
• “Glycemic control is not affected by season in MiniMed™ 780G system users – a real-world study from Italy” – short oral discussion (850) by Emanuele Bosi, Head physician of the General Medicine, Diabetes and Endocrinology Department and Director of the Diabetes Research Institute at Ospedale San Raffaele, Italy on Wednesday, September 11 at 12:45 CEST (Venue: Station 13)  
• “GLP-1 receptor agonist effects in people with type 2 diabetes using MiniMed™ advanced hybrid closed-loop therapy” – short oral discussion (775) by John Shin, Ph.D., MBA, Senior Clinical Research Director, Medtronic Diabetes on Thursday, September 12 at 12:45 CEST (Venue: Station 11)  
• “Postprandial insulin strategy for improving glycemic control after a missed meal bolus in persons with type 1 Diabetes users of the Advanced Hybrid Closed Loop (AHCL) Minimed 780G™ system.” – short oral discussion (781) by Prof. Bruno Grassi MD, Nutrition, Diabetes and Metabolism unit, Pontificia Universidad Católica de Chile on Thursday, September 12 at 14:00 CEST (Venue: Station 11)  
• “Real-world performance of the Minimed™ 780G safe meal bolus feature” – short oral discussion (782) by Venkataramana Putcha, Principal AI Data Science Engineer, Medtronic Diabetes on Thursday, September 12 at 14:00 CEST (Venue: Station 11)  
• “Advanced hybrid closed loop compared to standard insulin therapy in type 1 diabetes during delivery and early postpartum” - short oral discussion (820) by Kaat Beunen, PhD scientist at KU Leuven, on Thursday, September 12 at 12:45 CEST (Venue: Station 12)  
• “Cardiopulmonary and aerobic exercise tests assessing multiple biomarkers and hormones in type 1 diabetes under different circumstances: the act-one study” –oral presentation (LBA OP O2) by Francesca De Ridder, PhD scientist at University of Antwerp, on Tuesday, September 10 at 15:45 CEST (Venue: Cairo Hall)

MEDTRONIC SPONSORED EVENTS Medtronic Symposium: “Expanding Horizons in Insulin Therapy: Applications of MiniMed™ 780G system. Monday, September 9, from 13:30-15:00 CET (06:30-08:00 CT) (Venue: Sydney Hall and online), chaired by Prof. Dídac Mauricio, MD PhD, Director of the Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau CIBERDEM, Spain and Prof. Ohad Cohen, MD, Senior Global Medical Affairs Director, Medtronic Diabetes.

• “Addressing the needs of all people living with type 1 diabetes”, chaired by Dr. Martín Cuesta, Hospital Clínico San Carlos, Madrid, Spain and Prof. Ohad Cohen, MD, Senior Global Medical Affairs Director, Medtronic Diabetes with speakers on Thursday, September 12 from 12:15-12:45 CET (05:15-05:45 CT)  
• “New generation of Smart MDI therapy,” on Tuesday, September 10 at 10:30 CEST and Wednesday, September 11 at 10:30 CEST by Madison Smith, Ph.D., R.N., CDCES, R&D Senior Clinical Product Manager, Medtronic Diabetes  

* The MiniMed™ 780G system has not been approved for use for children aged 2-6 years, pregnancy, or type 2 diabetes by the FDA or other regulatory bodies. 1 Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care 2019; 42: 1593–603. 2 Benhalima K, Beunen K, Siegelaar SE, et al. Management of type 1 diabetes in pregnancy: update on lifestyle, pharmacological treatment, and novel technologies for achieving glycaemic targets. Lancet Diabetes Endocrinol 2023; 11: 490–508. 3 ElSayed NA, Aleppo G, Aroda VR, et al. 15. Management of diabetes in pregnancy: standards of care in diabetes—2023. Diabetes Care 2023; 46 (suppl 1): S254–66.

About the Diabetes Business at Medtronic ( www.medtronicdiabetes.com ) Medtronic Diabetes is on a mission to alleviate the burden of diabetes by empowering individuals to live life on their terms, with the most advanced diabetes technology and always-on support when and how they need it. We've pioneered first-of-its-kind innovations for over 40 years and are committed to designing the future of diabetes management through next-generation sensors (CGM), intelligent dosing systems, and the power of data science and AI while always putting the customer experience at the forefront.

About Medtronic Bold thinking. Bolder actions. We are Medtronic. Medtronic plc, headquartered in Galway, Ireland, is the leading global healthcare technology company that boldly attacks the most challenging health problems facing humanity by searching out and finding solutions. Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 95,000+ passionate people across more than 150 countries. Our technologies and therapies treat 70 health conditions and include cardiac devices, surgical robotics, insulin pumps, surgical tools, patient monitoring systems, and more. Powered by our diverse knowledge, insatiable curiosity, and desire to help all those who need it, we deliver innovative technologies that transform the lives of two people every second, every hour, every day. Expect more from us as we empower insight-driven care, experiences that put people first, and better outcomes for our world. In everything we do, we are engineering the extraordinary. For more information on Medtronic (NYSE:MDT), visit www.Medtronic.com and follow Medtronic on LinkedIn .

Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic's periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results.

For more information, contact: Ashley Patterson Global Communications +1-818-576-3025

Ryan Weispfenning Investor Relations +1-763-505-4626

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TEACHING TIPS: TWELVE TIPS FOR MAKING CASE PRESENTATIONS MORE INTERESTING *

1. set the stage.

Prepare the audience for what is to come. If the audience is composed of people of mixed expertise, spend a few minutes forming them into small mixed groups of novices and experts. Explain that this is an opportunity for the more junior to learn from the more senior people. Tell them that the case to be presented is extremely interesting, why it is so and what they may learn from it. The primary objective is to analyze the clinical reasoning that was used rather than the knowledge required, although the acquisition of such knowledge is an added benefit of the session. A “well organized case presentation or clinicopathological conference incorporates the logic of the workup implicitly and thus makes the diagnostic process seem almost preordained”.

A psychiatry resident began by introducing the case as an exciting one, explaining the process and dividing the audience into teams mixing people with varied expertise. He urged everyone to think in ‘real time’ rather than jump ahead and to refrain from considering information that is not normally available at the time: for example, a laboratory report that takes 24 hours to obtain be assessed in the initial workup.

2. PROVIDE ONLY INITIAL CUES AT FIRST

Give them the first two to live cues that were picked up in the first minute or two of the patient encounter either verbally, or written on a transparency. For example, age, sex race and reason for seeking medical help. Ask each group to discuss their first diagnostic hypotheses. Experts and novices will learn a great deal from each other at this stage and the discussions will be animated. The initial cues may number only one or two and hypothesis generation occurs very quickly even in the novices. Indeed, the only difference between the hypotheses of novices and those of experts is in the degree of refinement, not in number.

It is Saturday afternoon and you are the psychiatric emergency physician. A 25-year-old male arrives by ambulance and states that he is feeling suicidal. Groups talked for 4 minutes before the resident called for order to commence step three.

3. ASK FOR HYPOTHESES AND WRITE THEM UP ON THE BLACKBOARD

Call for order and ask people to offer their suggested diagnoses and write these up on a board or transparency.

The following hypotheses were suggested by the groups and the resident wrote them on a flip chart: depression, substance abuse, recent social stressors-crisis, adjustment disorder, organic problem, dysthymia, schizophrenia, bipolar affective disorder. The initial three or four bits of information generated eight hypotheses.

4. ALLOW THE AUDIENCE TO ASK FOR INFORMATION

After all hypotheses have been listed instruct the audience to ask for the information they need to confirm or refute these hypotheses. Do not allow them to ‘jump the gun’ by asking for a test result, for example, that would not have been received within the time frame that is being re-lived. There will be a temptation to move too fast and the exercise is wasted if information is given too soon. Recall that the purpose is to help them go through a thinking process which requires time.

Teachers participating in this exercise will receive much diagnostic information about students’ thinking at this stage. Indeed, an interesting teaching session can be conducted by simply asking students to generate hypotheses without proceeding further. There is evidence to suggest that when a diagnosis is not considered initially it is unlikely to be reached over time, Hence it is worth spending time with students to discuss the hypotheses they generate before they proceed with an enquiry.

Directions to the group were to determine what questions they would like to ask, based on gender, age and probabilities, to support or exclude the listed diagnostic possibilities. A sample of question follow:

• Does he work? No, he's unemployed.
• Does he drink? one to three beers a week.
• Why now? He's been feeling worse and worse for the last 3 weeks.
• Social support? He gives alone. Has no girlfriend.
• Appearance? Looks his age. Not shaved today. No shower in 3 days.
• Cultural background? Refugee from Iraq. Muslim.
• How did he get here? He spent 4 years in a refugee camp after spending 4 months walking to Pakistan from Iraq. He left Iraq to avoid military service.
• Suicide thoughts? Increasing the last 3 weeks. He was admitted in December and has been taking chloral hydrate.

This step took 13 minutes.

5. HAVE THE AUDIENCE RE-FORMULATE THEIR LIST OF HYPOTHESES

After enough information has been gained to proceed, ask them to resume their discussion about the problem and reformulate their diagnostic hypotheses in light of the new information. Instruct them to discuss which pieces of information changed the working diagnosis and why. Call for order again and ask people what they now think.

After allowing the group to talk for a few minutes, the resident asked them if there was enough information to strike off any hypotheses or if new hypotheses should be added to the list. One more possibility was added, post-traumatic stress disorder (PTSD). One group's list of priorities was major affective disorder with psychosis, schizophrenia, personality disorder. Another group also placed affective disorder first followed by organic mood disorder.

This step took 25 minutes.

6. FACILITATE A DISCUSSION ABOUT REASONING

Alter the original lists of hypotheses on the board in light of the discussion, or allow one member from each group to alter their own lists. By the use of open-ended questions encourage a general discussion about the reasons a group has for preferring one diagnosis over another.

A general discussion ensued about reasons for these priorities. Then the list was altered so that it read: schizophrenia, personality disorder, PTSD, major affective disorder with psychosis, organic mood disorder.

7. ALLOW ANOTHER ROUND OF INFORMATION SEEKING

Continue with another round of information and small-group discussion or else allow the whole group to interact. By giving information only when asked for and only in correct sequence, each person is challenged to think through the problem.

More information was sought, such as: form of speech? eye contact? affect? substance use? After 5 minutes the resident asked if there were only lab tests they would like. The group asked for thyroid stimulating hormone, T4, electrolytes and were given the results. They also asked for the results of the physical examination and were told that the pulse was 110 and the thyroid was enlarged. At this point some hypotheses were removed from the list.

8. ASK GROUPS TO REACH A FINAL DIAGNOSIS

When there is a lull in the search for information, ask the groups to reach consensus on their final diagnosis, given the information they have. Allow discussion within the groups.

9. CALL FOR EACH GROUP'S FINAL DIAGNOSIS

On each group's list of hypothesis, star or underline the final diagnosis.

The group decided that the most likely diagnosis was affective disorder with psychosis, the actual working diagnosis of the patient.

10. ASK FOR MANAGEMENT OPTIONS

If there is enough time, ask them to form small groups again to discuss treatment options, or conduct the discussion as a large group. Again ask for the reasons why one approach is preferred over another. Particularly ask the experts in the room for their reasoning so that the novices can learn from them.

11. SUMMARIZE

By the time the end is in sight the audience will be so involved that they will not wish to leave. However, 5 minutes before time, call for order and summarize the session. Highlight the key points that have been raised and refer to the objective of the session.

We are now at the end of our time. You have all had the opportunity to use your clinical reasoning skills to generate several hypotheses which are shown on the board. Initially you thought it possible that this man could have any one of a number of diagnoses including depression, substance abuse, adjustment disorder with depressed mood, organic mood disorder or post-traumatic stress disorder. With further information the possible diagnosis shifted to include schizophrenia and personality disorder as well as depression with psychotic features. Finally the diagnosis of depression or mood disorder with psychosis was most strongly supported because of the history of consistently depressed mood over several months, along with disturbed sleep, poor appetite, weight loss, decreased energy and diminished interest in most activities. The initially abnormal thyroid test proved to be a red herring so organic mood disorder related to hyper- or hypo-thyroidism was excluded. Additionally absence of vivid dreams involving a traumatic event made a diagnosis of post-traumatic stress disorder unlikely. Although a diagnosis of schizophrenia could not be totally excluded, this seemed less likely given the findings.

12. CLOSE THE SESSION WITH POSITIVE FEEDBACK

In some respects, but only some, teaching is like acting and one should strive to leave them not laughing as you go, but feeling that they have learned something.

The more novice members of the group have learned from the more experienced and all your suggestions have been valid. It has been interesting for me to follow your reasoning and compare it with mine when I actually saw this man. You have given me a different perspective as you thought of things I had not, and I thank you for your participation.

Although case presentation should be a major learning experience for both novice and experienced physicians they are often conducted in a stultifying way that defies thought. We have presented a series of steps which, if followed, guarantee active participation from the audience and ensure that if experts are in the room their expertise is used. Physicians have been moulded to believe that teaching means telling and, as a consequence, adopt a remote listening stance during case presentations. Indeed the back row often use the time to catch up on much needed sleep! Changing the format requires courage. We urge you to try out these steps so that both you and your audience will learn from and enjoy the process.

• Open access
• Published: 02 September 2024

Clinical profiles and mortality predictors of hospitalized patients with COVID-19 in Ethiopia

• Eyob Girma Abera   ORCID: orcid.org/0000-0002-9030-4328 1 , 2 ,
• Kedir Negesso Tukeni 3 , 4 ,
• Temesgen Kabeta Chala 5 ,
• Daniel Yilma 2 , 3 &
• Esayas Kebede Gudina 2 , 3  

BMC Infectious Diseases volume  24 , Article number:  908 ( 2024 ) Cite this article

Metrics details

Studying the characteristics of hospitalized Coronavirus Disease 2019 (COVID-19) patients is vital for understanding the disease and preparing for future outbreaks. The aim of this study was to analyze and describe the clinical profiles and factors associated with mortality among COVID-19 patients admitted to Jimma Medical Center COVID-19 Treatment Center (JMC CTC) in Ethiopia.

All confirmed COVID-19 patients admitted to JMC CTC between 17 April 2020 and 05 March 2022 were included in this study. Socio-demographic data, clinical information, and outcome variables were collected retrospectively from medical records and COVID-19 database at the hospital. Bivariable and multivariable analyses were performed to determine factors associated with COVID-19 severity and mortality. A P-value < 0.05 was considered statistically significant.

A total of 542 confirmed COVID-19 patients were admitted to JMC CTC, of which 322 (59.4%) were male. Their median age was 48 years (IQR 32–64). About 51% ( n  = 277) of them had severe COVID-19 upon admission. Patients with hypertension [AOR: 2.8 (95% CI: 1.02–7.7, p  = 0.046)], diabetes [AOR: 8.8 (95% CI: 1.2–17.3, p  = 0.039)], and underlying respiratory diseases [AOR: 18.8 (95% CI: 2.06–71.51, p  = 0.009)] were more likely to present with severe COVID-19 cases. Overall, 129 (23.8%) died in the hospital. Death rate was higher among patients admitted with severe disease [AHR = 5.5 (3.07–9.9) p  < 0.001)] and those with comorbidities such as hypertension [AHR = 3.5 (2.28–5.41), p  < 0.001], underlying respiratory disease [AHR = 3.4 (1.97–5.94), p  < 0.001], cardiovascular disease (CVDs) [AHR = 2.8 (1.73–4.55), p  < 0.001], and kidney diseases [AHR = 3.7 (2.3–5.96), p  < 0.001].

About half of COVID-19 cases admitted to the hospital had severe disease upon admission. Comorbidities such as hypertension, diabetes, and respiratory diseases were linked to severe illness. COVID-19 admissions were associated with high inpatient mortality, particularly among those with severe disease and comorbidities.

Peer Review reports

Introduction

More than four years after its declaration as a global pandemic, COVID-19 remains a dynamic public health concern, with the emergence of new variants influencing transmission patterns and epidemiological trends [ 1 , 2 ]. While global vaccination efforts have significantly reduced severe cases and mortality, disparities in vaccine access and uptake persist, especially in low- and middle-income countries [ 3 ]. By late 2023, there was a notable resurgence of cases in several regions, including Europe and North America, primarily due to the emergence of more transmissible variants [ 4 ]. In sub-Saharan Africa, challenges such as limited healthcare infrastructure and underreporting of cases continue to pose significant obstacles. Many African countries still experience lower testing rates compared to other regions, contributing to an underestimation of the true burden of COVID-19 [ 5 ]. The gap between documented cases and estimated seroprevalence rates suggests ongoing underreporting, underscoring the need for improved surveillance and reporting systems to better capture the pandemic’s full impact [ 6 , 7 ].

Vaccinations have significantly reduced COVID-19 transmission, severe illness, and mortality. However, disparities in vaccine distribution and acceptance, especially in low- and middle-income countries, hinder global herd immunity [ 8 , 9 ]. Africa faces particular challenges with low vaccination rates due to supply shortages, logistical issues, vaccine hesitancy, and limited healthcare infrastructure [ 10 , 11 ]. The emergence of new SARS-CoV-2 variants complicates efforts to combat the pandemic, as these variants may affect transmissibility, disease severity, and vaccine efficacy [ 12 , 13 , 14 ]. Some variants, like Delta, have shown increased transmissibility and can lead to breakthrough infections among vaccinated individuals, partly due to mutations in the spike protein [ 15 ].

Various risk factors are associated with severe illness and mortality from COVID-19. These include advanced age, underlying health conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease, obesity, and states of immunocompromise [ 16 , 17 ]. Furthermore, demographic factors such as male gender [ 18 ], socioeconomic status, and access to healthcare resources have also been recognized as playing roles in determining the severity and fatality of the disease [ 19 ].

Ethiopia faced significant challenges during the COVID-19 pandemic, including limited healthcare infrastructure and economic constraints [ 20 ]. The government quickly implemented measures such as lockdowns, travel restrictions, and hygiene promotion [ 21 ]. Despite these efforts, the country’s response was hampered by limited testing and medical resources [ 22 ]. The Ethiopian Public Health Institute and the Ministry of Health led initiatives for surveillance, contact tracing, and public awareness, with international support, including vaccines through COVAX [ 23 ]. The response aimed to balance public health measures with economic and social impacts, highlighting the challenges of managing a pandemic in a developing country [ 24 , 25 ].

Furthermore, the lack of comprehensive scientific data on COVID-19 outcomes has hindered evidence-based decision-making and the implementation of targeted public health interventions in Ethiopia. Strengthening research infrastructure and fostering international collaborations will not only enhance the current response but also pave the way for more effective future preparedness efforts, ensuring the protection of public health in Ethiopia and beyond [ 26 ]. Therefore, this study aimed to assess the clinical profile and outcomes of hospitalized COVID-19 patients at Jimma Medical Center (JMC) in southwest Ethiopia.

Study design and setting

We reviewed medical records of all patients admitted with COVID-19 to the Jimma Medical Center (JMC) COVID-19 Treatment Center (CTC) between 17 April 2020 and 05 March 2022. The center, established on 13 March 2020, had a capacity of 23 beds and was equipped with mechanical ventilators, oxygen concentrators, and patient monitors. Integrated with JMC, it was the only COVID-19 intensive care facility in southwest Ethiopia. The center consisted of management and operation sections, with the management team including a scientific advisory council and the operation section divided into six sub-teams: [ 1 ] Isolation & Case Management, [ 2 ] Surveillance, [ 3 ] Risk Communication & Community Engagement (RCCE), [ 4 ] Water, Sanitation, & Hygiene (WASH) and Infection Prevention Control (IPC), [ 5 ] Research, Innovation, and Diagnostics, and [ 6 ] Administration, Data Management, and Finance [ 27 ].

Inclusion criteria

Patients whose medical records confirmed the presence of the virus through the identification of viral ribonucleic acid (RNA) in nasopharyngeal swab samples using reverse transcription polymerase chain reaction (RT-PCR) either upon admission or during hospitalization, regardless of whether they exhibited symptoms, were included in the study.

Data collection

Patient sociodemographic and clinical characteristics were collected from medical records and the COVID-19 database at JMC-CTC. The collected data included various aspects such as demographics, clinical manifestations, comorbidities, disease severity upon admission, time/date of admission, length of stay, and discharge outcome.

Operational definitions .

COVID-19 specific symptoms (classic): Fever, cough, shortness of breath, loss of smell or taste [ 28 ].

Extended symptoms: Sore throat, runny nose, arthralgia, fatigue, and headache [ 28 ].

Mild illness: A person has any of the COVID-19 symptoms except for shortness of breath and difficulty breathing [ 29 ].

Moderate illness: A person may have lower respiratory tract illness with clinical or radiographic evidence. However, their blood oxygen levels remain at 94% or higher [ 29 ].

Critical COVID: A COVID-19 case requiring mechanical ventilation or hemodynamic support. This includes patients with acute respiratory distress syndrome, multi-organ dysfunction or failure, and shock [ 29 ].

Non-severe COVID-19: A person with mild to moderate symptoms that do not require hospitalization. This includes individuals with mild symptoms (any COVID-19 symptoms except shortness of breath and difficulty breathing) and moderate symptoms (lower respiratory tract illness with clinical or radiographic evidence but blood oxygen levels at 94% or higher) [ 29 , 30 ].

Severe illness: A person has blood oxygen levels that are less than 94%, a high breathing rate (≥ 30 breaths/min), and signs of severe lung disease (lung infiltrates > 50%) [ 29 ].

Symptom categorization

Category 1: One or more classic symptom without extended symptoms.

Category 2: One or more classic symptom with extended symptom.

Category 3: One or more extended symptom without classic symptoms.

Data analysis

The original data collected in Microsoft Excel was reviewed for completeness and consistency before being exported to SPSS ® version 26 (IBM ® , New York, USA) for analysis. Normality tests were conducted using visual inspections of histograms and Q-Q plots, as well as the Kolmogorov-Smirnov and Shapiro-Wilk tests. For the bivariate analysis, independent variables with a p-value less than 0.25 were selected as candidates for the multivariable logistic regression analysis. A binary logistic regression model was then used to explore risk factors for the severity of COVID-19 infection. Additionally, a Cox regression analysis was employed to identify predictors of mortality in COVID-19 patients. The equality of survival distributions for different severity levels was tested using Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon), and Tarone-Ware tests. A p-value of less than 0.05 was used as the threshold for statistical significance.

Socio-demographic and clinical characteristics

From April 2020 to March 2022, a total of 542 COVID-19 patients were admitted to JMC CTC, of which 322 (59.4%) were male. The median age was 48 years (IQR 32–64), with a range of 3 to 102 years. More than half (50.8%) of the cases were younger than 50 years of age. The most frequently reported symptoms were dyspnea (60%) and cough (57.6%). Among those with severe disease, 57.4% and 54% of patients exhibited cough and dyspnea, respectively. Comorbidities were reported in 21.8% of the admitted patients. Among those who died, the majority had comorbidities (80.6%), with hypertension being the most common at 44.2% (Table  1 ).

Trends in COVID-19 admissions by severity

Until November 2020, most admissions were due to non-severe cases. Subsequently, the non-severe admission declined, while admissions due to severe cases gradually increased reaching peak of 49 in April 2021. From June to August 2021, only two cases, both of which were severe, were admitted to the center. The number of admissions, primarily due to severe cases, increased after September 2021 (Fig.  1 ).

Pattern of admission and clinical severity of COVID-19 cases admitted to JMC CTC since April 2020 to March 2022

Factors associated with COVID-19 severity

Univariate binary logistic regression analyses were conducted to assess the individual factors associated with severe COVID-19 cases. Subsequently, candidate variables for the final multivariate analysis were selected based on their statistical significance in the univariate analyses. Accordingly, age, admission symptoms, and comorbidities such as hypertension, diabetes, respiratory disease, cardiovascular diseases (CVDs), and kidney diseases, were selected for inclusion in the multivariate logistic regression analysis.

The analysis indicated that with each additional year of age, the odds of experiencing a more severe form of the disease increased by 4% (AOR: 1.04, 95% CI: 1.03–1.05, p  < 0.001).

Additionally, individual comorbidities were independently analyzed after adjusting for the presence and absence of comorbidities. Hypertensive patients showed a nearly threefold increased odds of more severe disease compared to non-hypertensive patients [AOR: 2.8 (95% CI: 1.02–7.7, p  = 0.046)]. Diabetic patients had approximately nine times higher odds of experiencing severe disease compared to non-diabetic patients [AOR: 8.8 (95% CI: 1.2–17.3, p  = 0.039)]. Patients with respiratory diseases exhibited the highest odds of severe disease, with an 18.8-fold increase compared to those without respiratory conditions [AOR: 18.8 (95% CI: 2.06–71.51, p  = 0.009)] (Table  2 ).

Mortality and discharge outcomes

A total of 129 (23.8%) patients died during their hospitalization. The median length of hospital stay was 9.5 days (IQR: 6–15), with duration ranging from one to 40 days. Most of the deceased patients ( n  = 81, 62.8%) died within the first 7 days of admission. Additionally, 120 (22.1%) patients were transferred to home-based care or nearby facilities for further treatment and follow-up.

Trend of mortality with severe case admission

During the first five months, there were no admissions of severe cases and death at the center. However, as time progressed, there was a gradual increase in severe cases, culminating in the highest number of deaths during three peak periods: April 2021 ( n  = 18), October 2021 ( n  = 19), and January 2022 ( n  = 16) (Fig.  2 ).

Trends in Mortality and Severe Case Admissions among COVID-19 Patients at JMC CTC from April 2020 to March 2022

Time to mortality and hazard factors in COVID-19 patients

The clinical severity status at admission was significantly associated with survival outcomes (p-value < 0.001) (Supplementary Table 1 ). Patients who were severely ill at the time of admission had poorer survival rates and a shorter time to death (Fig.  3 ).

Kaplan–Meier curves displaying the estimated survival time of patients with COVID-19 stratified by the severity status on admission and length of hospital stay at JMC CTC from April 2020 to March 2022

Univariate Cox regression analyses assessed individual factors associated with the hazard of death among COVID-19 patients. Variables with fewer than 5 occurrences were excluded due to insufficient sample size for reliable estimates. Factors significant in univariate analyses, including age, clinical severity, and comorbidities (hypertension, diabetes, respiratory disease, cardiovascular disease, and kidney disease), were selected for the multivariate Cox regression analysis.

Severe disease was associated with a 5.5-fold increased hazard of death compared to non-severe cases (AHR: 5.5; 95% CI: 3.07–9.9, p  < 0.001). Additionally, individual comorbidities were independently analyzed after adjusting for the presence and absence of comorbidities. Hypertension, respiratory disease, cardiovascular disease, and kidney disease were linked to increased COVID-19 mortality risk, with the following AHR and 95% CI: hypertension [3.5(2.28–5.41), p  < 0.001], respiratory disease [3.4(1.97–5.94), p  < 0.001], cardiovascular disease [2.8(1.73–4.55), p  < 0.001], and kidney disease [3.7(2.3–5.96), p  < 0.001] (Table  3 ).

A total of 542 patients were admitted to JMC CTC between April 2020 and March 2022. Cough and dyspnea were the most frequently reported symptoms. Approximately 51% of the patients were classified as having severe COVID-19 at the time of hospitalization. The mortality rate was 23.8%, with a significant majority of the deceased patients (80.6%) having comorbidities, particularly hypertension. Conditions such as hypertension, respiratory disease, and cardiovascular disease were strongly associated with severe outcomes and increased risk of mortality.

During the first few months of the COVID-19 pandemic, Ethiopia did not experience a major outbreak with very low mortality rate [ 31 ]. However, by August 2020, the country began active case finding through a large-scale community-based activity and testing (CoMBaT) strategy [ 32 ]. This resulted in an increase in admissions for both severe and non-severe cases. Our study also revealed that there were no admissions due to severe COVID-19 or COVID-19 related deaths at JMC until August 2020. The low number of cases during that period may have been a result of limited testing and low disease outbreak. However, starting in September 2020, non-severe admissions decreased as Ethiopia revised its strategy of blanket admission of all confirmed COVID-19 cases to only severe cases and high-risk patients.

Since February 2021, there has been a notable increase in severe cases. The highest number of overall admissions occurred in April 2021, with a majority being severe cases ( n  = 49) out of a total of 69 admissions. Following this peak, there was a substantial decline over the next four months: May ( n  = 29), June ( n  = 0), July ( n  = 0), and August ( n  = 2). This pattern can be attributed to the second wave, which began in late January 2021 and persisted until the end of May 2021 [ 33 ]. During this period, the Alpha variant, known for its increased transmissibility [ 34 ] and higher hospitalization rates compared to earlier strains [ 35 ], predominated COVID-19 cases in Ethiopia [ 33 ]. These findings align with a study conducted from publicly available data on COVID-19 admissions in Ethiopia [ 36 ]. Our study also revealed that admissions due to severe COVID-19 and deaths peaked in October 2021 and January 2022. These peaks corresponded with the third and the fourth waves of COVID-19 outbreak in Ethiopia, which were dominated by the Delta and Omicron variants, respectively [ 37 ].

Ethiopia began COVID-19 vaccination in March 2021 [ 38 ]. Although the number of admissions and deaths at the hospital significantly decreased between May and August 2021, it is difficult to attribute this to the vaccination because only less than 5% of the population was vaccinated during this time [ 39 ].

Clinical parameters, including symptom category at admission and pre-existing comorbidities, were found to be associated with COVID-19 severity. Patients with one or more classic COVID-19 symptoms were more likely to present with severe illness compared to asymptomatic individuals by 15.9 folds. The odds increased to 17.2 among those with classic symptoms plus extended symptoms. This finding aligns with a retrospective analysis from China, which reported that the likelihood of developing severe illness increased with an increasing number of presenting symptoms at hospital admission [ 40 ]. This finding is also consistent with a global systematic review and meta-analysis that involved data from 14 countries [ 41 ]. Previous studies have suggested that an aberrant host immune response and cytokine storm may significantly contribute to the severity of COVID-19 [ 42 ].

In this study, age was associated with the severity of COVID-19. For each additional year of age, the likelihood of experiencing a more severe form of the disease increased by 4%, which aligns with findings from previous studies [ 43 , 44 , 45 ]. Additionally, patients with comorbidities such as hypertension, diabetes, and respiratory diseases were more likely to experience severe COVID-19 illness. Several systematic reviews have found similar patterns in both developing and developed countries, indicating that the relationship between comorbidities and the severity of COVID-19 is consistent across different socioeconomic contexts [ 41 , 46 , 47 ].

The median length of hospital stay was 9.5 days (IQR 6–15), with range of one to 40 days. This is consistent with findings from other studies conducted in Ethiopia [ 48 , 49 ]. However, this finding is lower than studies from China [ 50 ], US [ 51 ], and Sweden [ 52 ]. The shorter median hospital stay observed in our study compared to those from China, the US, and Sweden may reflect variations in treatment protocols, healthcare resources,, and patient demographics across these regions.

Our study also showed that clinical severity and pre-existing comorbidities were significantly associated with the risk of death. Severe disease was associated with a 5.5-fold increased hazard of death compared to non-severe cases. This finding is consistent with systematic reviews and meta-analyses from Sub-Saharan countries [ 53 ] as well as Asia, North America, Europe, and South America [ 54 ]. Additionally, comorbidities including, hypertension (AHR: 3.5), respiratory disease (AHR: 3.4), cardiovascular disease (AHR: 2.8), and kidney disease (AHR: 3.7) were linked to increased COVID-19 mortality risk. Our findings are consistent with different systematic review meta-analysis studies [ 53 , 54 , 55 , 56 , 57 , 58 ]. This is because chronic conditions are often associated with a subclinical inflammation, weakened innate immune responses, and increased expression of ACE-2 receptor, which facilitates the entry of SARS-CoV-2 into the host cells and is associated with higher COVID-19 mortality [ 45 ].

Strength and limitation

This study covered nearly two years of COVID-19 pandemic, focusing on COVID-19 related hospitalizations to a tertiary teaching hospital in Ethiopia, and provides valuable insights into COVID-19 in African contexts. While the study offers original findings, it is limited by its retrospective design. Retrieving data from medical records was found to be a challenge due to incomplete documentations and lost records. Moreover, the lack of routinely recorded laboratory and imaging results, as well as case management details, prevented their inclusion in this study.

This study found that patients hospitalized with severe symptoms and comorbidities—such as hypertension, respiratory disease, cardiovascular disease, and kidney disease—faced a significantly higher risk of in-hospital mortality. The study also identified distinct patterns in admissions and mortality that corresponded with the pandemic waves and variant prevalence in Ethiopia. Although vaccination efforts began in March 2021, their impact on admissions and mortality was minimal during the study period due to low vaccination coverage. Overall, this research enhances our understanding of COVID-19 outcomes in African contexts and highlights the importance of ongoing monitoring and management, especially with the emergence of new variants and evolving data.

Data availability

All relevant data are within the manuscript.

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Acknowledgements

We extend our heartfelt gratitude to the Jimma Emergency Operation Center, Jimma Medical Center, and the dedicated study teams for their invaluable support during the intervention and data collection process.

This research received no specific grant from any funding agency in the public, commercial, or non-profit sectors.

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Department of Public Health, Jimma University, P.O.Box 378, Jimma, Oromia, Ethiopia

Eyob Girma Abera

Clinical Trial Unit, Jimma University, Oromia, Ethiopia

Eyob Girma Abera, Daniel Yilma & Esayas Kebede Gudina

Department of Internal Medicine, Jimma University, Jimma, Oromia, Ethiopia

Kedir Negesso Tukeni, Daniel Yilma & Esayas Kebede Gudina

Center Hospitalier Saint-Joseph Saint-Luc, Lyon, France

Kedir Negesso Tukeni

Department of Health Policy and Management, Jimma University, Jimma, Oromia, Ethiopia

Temesgen Kabeta Chala

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Contributions

EGA and EKG conceptualized and designed the study. EGA analyzed the data and wrote the original draft. TKC and KNT involved for data curation. EKG and DY provided supervision for the overall activities. All authors accepted responsibility for all aspects of the research, including writing, reviewing, and editing, and approved the final version of the manuscript.

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Correspondence to Eyob Girma Abera .

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Ethical approval for the study was obtained from the Institutional Review Board (IRB) of Jimma University, Institute of Health (Reference number: RPGD/978/2020). The IRB of Jimma University, Institute of Health, also granted a waiver for the requirement of informed consent to participate, as the study involved a retrospective review of anonymized medical records. All data were handled with strict confidentiality to ensure participant anonymity.

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Abera, E.G., Tukeni, K.N., Chala, T.K. et al. Clinical profiles and mortality predictors of hospitalized patients with COVID-19 in Ethiopia. BMC Infect Dis 24 , 908 (2024). https://doi.org/10.1186/s12879-024-09836-6

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Received : 02 April 2024

Accepted : 29 August 2024

Published : 02 September 2024

DOI : https://doi.org/10.1186/s12879-024-09836-6

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