Grand Rounds

You are expected to make good use of audiovisual aids.

Be sure you effectively utilize any images that accompanied your case. Consult with the faculty facilitating your case to help you understand any projected images depicting cytology, histopathology, radiography, etc. Then, during the presentation, it is your responsibility to adequately explain and point to the salient features. If you’re not sure, just ask for help!

You should make effective use of projected text by using the form of PowerPoint slides or Prezi.

You might consider projecting a flow chart of the case. Likewise you are encouraged to use any figures that illustrate the pathophysiology and important diagnostic procedures or tests.

A little practice will go a long way towards making your presentation go smoothly!

Don’t forget that a 15 minute timer will be running.

You will then have 4-5 minutes to answer questions.

resentation Outline:

1. Begin with Case Summary (allow 5-10 minutes)
   1. Basically, take the audience briefly through the case as your clinic saw it.
   2. Be sure to highlight:
      1. The important points / findings at each step. (Don’t worry about normal data, unless it’s important.)
      2. Differential Diagnoses and how they changed as the case progressed – for example show/discuss your problem list and DfDx’s as you worked through the case.
      3. Important decisions that the clinic made (or didn’t make)
      4. Dilemmas in the case that your clinic faced
      5. Any public health considerations
   3. The case summary should include approach, current diagnosis, prognosis, and (if appropriate) a brief recommended therapeutic plan.
   4. Don’t spend much time on treatment unless it was an essential part of the case. Likewise, don’t discuss normal findings unless they were pertinent and/or allowed you to rule out DfDx’s.
2. Review the condition/disease, including the pathophysiology
   1. You will usually need to reserve at least 5 minutes for the review.
   2. Remember one of the primary goals of these cases is for you to learn basic mechanisms of disease and laboratory diagnosis, as well as to practice your problem solving and interpersonal skills.
   3. Be sure to discuss the prognosis for your case.
3. The Learning Issues:
   1. What did you learn from the case?
   2. This is one of THE most important parts of your presentations, so give it some careful thought and a bit of significant time during your presentation. The DC faculty LOVE insightful Learning Issues and have been known to deduct points when they think the issues were superficial and/or incomplete.
   3. For the purposes of the exercise, the DC faculty is especially interested in what you learned about pathophysiology, clinical pathology, infectious diseases, immunology, toxicology and/or public health.
   4. However, the learning issues include much more than the disease you diagnosed.
   5. For example, your learning issues might include client-veterinarian communication, approaches to clinical problem solving, dilemmas of non-invasive versus invasive procedures, interpersonal considerations, communication with referring veterinarians and consultants, references and sources of information, etc., etc.
   6. Therefore, near the end of your presentation, list and discuss “What we learned”.
4. At the very end, project your final billing statement to the client.

The intention of the handout is to be a supplement form that would be used in a Continuing Education (CE) case presentation that you would be giving to your colleagues in a practice or at a local conference. It is a take away from the PowerPoint presentation and disease – NOT a recap of the presentation.

Handout Format:

At the top of your handout, indicate the Group Number, Clinic Name, Names of the Clinic Members, and Date.

MUST be limited to 1 sheet of paper duplexed (i.e. the front & back of one piece of paper) – Use all the available space. If you’re not using all of the front and back, you’re probably not using the space very effectively.

• Font size no larger than 12 pt
• Margins of .75 inch all the way around
• Single Spaced

It is fine to incorporate figures so long as they contribute positively to the document, you cite the reference, and they take less than 25% of space in the entire handout.

The handout should be written primarily in NARRATIVE form (NOT outline form). Figures that were used as part of your presentation and which illustrate key points are welcome (again <25% including pictures).

If you want some input, ask your facilitator to read a draft of your handout. If he or she has time, they’ll be happy to take a look and provide some suggestions.

Handout Content:

Your handout should provide a brief overview of the case and the disease or diseases you examined. It should be a supplement to the presentation, not a replication of the same content. Again, the handout should reflect a CE case presentation that you would give to colleagues.

Your handout should NOT reiterate the facts of the case.

• In other words, except for some basic information on signalment, presenting complaints and problems (not to exceed 5 sentences), you do not need to write a case description or case report. The oral presentation is the place to report on your case and the methods your clinic used to make a diagnosis. On the other hand, you do want to make sure your handout captures the key findings/problems in the case and, if appropriate, any critical DfDx’s.

However, a classmate or DC faculty member should be able to go back to your handout for:

• A review of the condition you diagnosed with an emphasis on pathophysiology, common problems, diagnosis, and treatment plan.
  • For cases in which there were several very important DfDx’s, consider reviewing those as well. Do not neglect aspects of the disease and/or case that are applicable to the instructors and courses that participate in the Diagnostic Challenges. These include pathology, clinical pathology, bacteriology/mycology, virology, toxicology and immunology. It is fine to incorporate figures so long as they contribute positively to the document, you cite the reference and they take less than 25% of space in the entire handout.
• Pertinent information on any public health aspects of the case.
• A list of 2-3 key quality references.
  • This is an abbreviated bibliography extracted from your literature search. Do NOT include standard textbook references like sections in Ettinger, Smith, etc. The bibliography should provide references that your classmates might not otherwise find immediately. (Early submission to your facilitator can be submitted for feedback during the DC week)

As will be expected in the veterinary teaching hospitals at WSU, your Medical Record should be clear, complete, organized and free of extraneous pieces of paper.

Ideally, the reader should be able to review your Medical Record and retrospectively follow your thought processes as you worked through the case.

The record should also provide an accurate legal record of the case.

Materials required to be in your medical record when submitted:

• Master Problem List
• Progress Notes (including Assessment, Differential Diagnoses and Plan)
• Data Base (e.g. lab results, history, PE findings, signalment, etc)
• All SOAPs
• Phone log/Communications
• Discharge Instructions or final documentation of case
• Final Bill
• Grand Rounds Handout
• A copy of 1 key article