gave a speech with written medical notes beforehand

Gave a speech with rewritten medical notes beforehand (9)

I believe the answer is:

' gave a speech ' is the definition. The definition and answer can be both to do with communicating as well as being past participle verbs. Maybe you can see a link between them that I don't see? ' rewritten medical notes beforehand ' is the wordplay. ' rewritten ' indicates an anagram. ' notes ' becomes ' de ' (two musical notes) . ' beforehand ' says to put letters next to each other. ' medical ' is an anagram of ' claimed '. ' claimed ' put after ' de ' is ' DECLAIMED '. ' with ' acts as a link.

Can you help me to learn more ?

(Other definitions for declaimed that I've seen before include "Pronounced" , "Read aloud" .)

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Pros and Cons of Written Notes vs Dictation in Healthcare

By Jamie Frew on Jun 16, 2024.

Fact Checked by Ericka Pingol.

Understanding the concepts of written notes and medical dictation in healthcare

Maintaining clinical notes and documentation is an essential aspect of working as a healthcare practitioner, and there are a few different ways that this process can be carried out. Keeping handwritten notes is the most traditional method, and whilst it can be effective, it is generally more time-consuming and error-prone. The most recently adopted method of maintaining medical notes is by using dictation software. This software allows the practitioner to speak into their computer or mobile device, which will consequently translate what they are saying into readable text. Using medical dictation over written notes is the most effective way to save time, improve productivity and focus on delivering quality healthcare to patients in need.

Typing vs dictating notes: which is better?

Before we dive into analyzing the pros and cons of typing versus dictating notes, we should preface that regardless of what conclusion we come to, you will have your preferences. That being said, it is always important to critically analyze your working methods to identify whether improvements can, and should, be made.

Since the mass movement to implement EHR (electronic health record) systems into healthcare practices, the majority of practitioners typed their notes. Now, with the introduction of voice dictation software, many providers can’t decide which option to go with. To help you make the right choice, we have broken down the various advantages and disadvantages associated with each method:

Efficiency : This is generally one of the biggest points of discussion. Completing paperwork and clinical documentation takes up a significant amount of time for practitioners and is one of the main barriers preventing the treatment of more patients. As such, healthcare practices are constantly looking for the most time-efficient method of completing paperwork. Although there are a few factors that go into it, dictation is generally a faster method than typing. Typing requires a certain level of skill, whereas there is no prerequisite for speaking on a phone. A study conducted by Stanford researchers found that dictation is almost three times faster than typing.

Accuracy : You may be wondering whether the speed with which dictation occurs is correlated with a higher rate of errors. Fortunately, this is not the case, and research indicates that dictated notes are just as accurate as carefully typed notes. In saying that, sending dictations to third-party transcription services has been shown to result in a higher number of errors than using front-end voice-to-text dictation software. This latter type of dictation allows physicians to view their transcription as it is being produced and fix any mistakes immediately.

Efficiency and accuracy are the two most significant factors that should be considered when deciding whether to type or dictate your clinical notes. Careful analysis of both of these methods has revealed that dictation is not only the more efficient method but is also associated with fewer errors and doesn’t require a pre-existing skill. We understand that you may have your own preferences, but the vast advantages associated with using medical dictation software indicate that it is the preferable option. Not only does it give you just as much control as typing, but it will streamline the paperwork process and save you up a significant amount of time that can instead be spent doing what you do best: seeing and treating patients.

Tips to get the most out of dictations

Although medical dictation software is highly intuitive and you may find it comes easily to you, moving to a new system can be fairly daunting. To help ensure you are using the software to its full potential, we have compiled a brief list of strategies that will enable you to create the best notes possible:

• Enunciate : When using dictation software, you need to speak clearly. Although the software is highly advanced, it is still a computer and won’t be able to understand mumbled or unclear language. 
• Correct punctuation: You will need to dictate the punctuation within your transcription. This includes letting the software know where there is a full stop, comma, question mark, etc.
• Use sentences: The software has been designed to understand sentences and phrases over words. Separating all of your sentences into individual words can confuse the transcript, especially when using words like ‘to’, ‘too’, and ‘two’. The algorithm is sophisticated and understands context clues, so it is more efficient if you speak in sentences.

Adopt Carepatron's medical dictation software

Once you have decided to implement medical dictation software into your practice, it is time to decide which platform to use. In recent years, there has been a surge in the number of companies developing dictation software so we understand this can be a daunting decision - however, this is an area we are well versed in! Carepatron offers a highly sophisticated, medical dictation service that is guaranteed to save your practice significant amounts of time. The software is integrated into a high-performing EHR, allowing you to store all of your notes in a centralized database. Carepatron is also HIPAA-compliant and takes patient privacy seriously, meaning you can be confident that the information stored in the system is highly secure.

The technology of voice recognition today

There are various reasons behind why the development of voice dictation software is so useful in a medical context. One of the biggest factors is the fact that practitioners who are above a certain age bracket didn’t grow up with technology and are unfamiliar with typing in general, let alone typing quickly. Dictation eliminates the need for them to learn a new skill, and they can focus on producing good notes without the complication of typing. Further, since the development of dictation software, it is becoming increasingly sophisticated, yet remains easy to use. Practitioners can direct the software, which now listens to voice commands, allowing them to complete their paperwork without lifting a single finger. Further, dictation is now mobile-friendly, allowing practitioners to complete their paperwork remotely or on the go. Lastly, although technology is increasingly advancing, it isn’t getting more expensive. This means that healthcare practices can utilize the most recent forms of dictation software without having to pay excessive costs. The time and money-related advantages of implementing medical dictation software should not be overlooked, and if you are wanting to stay competitive in the healthcare industry, it is time to make the move.

Further Reading:

• Physician use of speech recognition versus typing in clinical documentation: A controlled observational study
• Writing in medical notes

Related Articles

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How to deliver an oral presentation

Georgina wellstead.

a Lister Hospital, East and North Hertfordshire NHS Trust

Katharine Whitehurst

b Royal Devon and Exeter Hospital

Buket Gundogan

c University College London

d Guy's St Thomas' NHS Foundation Trust, London, UK

Delivering an oral presentation in conferences and meetings can seem daunting. However, if delivered effectively, it can be an invaluable opportunity to showcase your work in front of peers as well as receive feedback on your project. In this “How to” article, we demonstrate how one can plan and successfully deliver an engaging oral presentation.

Giving an oral presentation at a scientific conference is an almost inevitable task at some point during your medical career. The prospect of presenting your original work to colleagues and peers, however, may be intimidating, and it can be difficult to know how to approach it. Nonetheless, it is important to remember that although daunting, an oral presentation is one of the best ways to get your work out there, and so should be looked upon as an exciting and invaluable opportunity.

Slide content

Although things may vary slightly depending on the type of research you are presenting, the typical structure is as follows:

• Opening slide (title of study, authors, institutions, and date)
• Methodology
• Discussion (including strengths and weaknesses of the study)

Conclusions

Picking out only the most important findings to include in your presentation is key and will keep it concise and easy to follow. This in turn will keep your viewers engaged, and more likely to understand and remember your presentation.

Psychological analysis of PowerPoint presentations, finds that 8 psychological principles are often violated 1 . One of these was the limited capacity of working memory, which can hold 4 units of information at any 1 time in most circumstances. Hence, too many points or concepts on a slide could be detrimental to the presenter’s desire to give information.

You can also help keep your audience engaged with images, which you can talk around, rather than lots of text. Video can also be useful, for example, a surgical procedure. However, be warned that IT can let you down when you need it most and you need to have a backup plan if the video fails. It’s worth coming to the venue early and testing it and resolving issues beforehand with the AV support staff if speaking at a conference.

Slide design and layout

It is important not to clutter your slides with too much text or too many pictures. An easy way to do this is by using the 5×5 rule. This means using no more than 5 bullet points per slide, with no more than 5 words per bullet point. It is also good to break up the text-heavy slides with ones including diagrams or graphs. This can also help to convey your results in a more visual and easy-to-understand way.

It is best to keep the slide design simple, as busy backgrounds and loud color schemes are distracting. Ensure that you use a uniform font and stick to the same color scheme throughout. As a general rule, a light-colored background with dark-colored text is easier to read than light-colored text on a dark-colored background. If you can use an image instead of text, this is even better.

A systematic review study of expert opinion papers demonstrates several key recommendations on how to effectively deliver medical research presentations 2 . These include:

• Keeping your slides simple
• Knowing your audience (pitching to the right level)
• Making eye contact
• Rehearsing the presentation
• Do not read from the slides
• Limiting the number of lines per slide
• Sticking to the allotted time

You should practice your presentation before the conference, making sure that you stick to the allocated time given to you. Oral presentations are usually short (around 8–10 min maximum), and it is, therefore, easy to go under or over time if you have not rehearsed. Aiming to spend around 1 minute per slide is usually a good guide. It is useful to present to your colleagues and seniors, allowing them to ask you questions afterwards so that you can be prepared for the sort of questions you may get asked at the conference. Knowing your research inside out and reading around the subject is advisable, as there may be experts watching you at the conference with more challenging questions! Make sure you re-read your paper the day before, or on the day of the conference to refresh your memory.

It is useful to bring along handouts of your presentation for those who may be interested. Rather than printing out miniature versions of your power point slides, it is better to condense your findings into a brief word document. Not only will this be easier to read, but you will also save a lot of paper by doing this!

Delivering the presentation

Having rehearsed your presentation beforehand, the most important thing to do when you get to the conference is to keep calm and be confident. Remember that you know your own research better than anyone else in the room! Be sure to take some deep breaths and speak at an appropriate pace and volume, making good eye contact with your viewers. If there is a microphone, don’t keep turning away from it as the audience will get frustrated if your voice keeps cutting in and out. Gesturing and using pointers when appropriate can be a really useful tool, and will enable you to emphasize your important findings.

Presenting tips

• Do not hide behind the computer. Come out to the center or side and present there.
• Maintain eye contact with the audience, especially the judges.
• Remember to pause every so often.
• Don’t clutter your presentation with verbal noise such as “umm,” “like,” or “so.” You will look more slick if you avoid this.
• Rhetorical questions once in a while can be useful in maintaining the audience’s attention.

When reaching the end of your presentation, you should slow down in order to clearly convey your key points. Using phases such as “in summary” and “to conclude” often prompts those who have drifted off slightly during your presentation start paying attention again, so it is a critical time to make sure that your work is understood and remembered. Leaving up your conclusions/summary slide for a short while after stopping speaking will give the audience time to digest the information. Conclude by acknowledging any fellow authors or assistants before thanking the audience for their attention and inviting any questions (as long as you have left sufficient time).

If asked a question, firstly thank the audience member, then repeat what they have asked to the rest of the listeners in case they didn’t hear the first time. Keep your answers short and succinct, and if unsure say that the questioner has raised a good point and that you will have to look into it further. Having someone else in the audience write down the question is useful for this.

The key points to remember when preparing for an oral presentation are:

• Keep your slides simple and concise using the 5×5 rule and images.
• When appropriate; rehearse timings; prepare answers to questions; speak slowly and use gestures/ pointers where appropriate; make eye contact with the audience; emphasize your key points at the end; make acknowledgments and thank the audience; invite questions and be confident but not arrogant.

Conflicts of interest

The authors declare that they have no financial conflict of interest with regard to the content of this report.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Published online 8 June 2017

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Medical Note: A Complete Guide for Healthcare Professionals

Table of contents.

As a physician or clinic administrator, you know how important medical notes are for documenting patient care, communicating with other healthcare providers, and supporting clinical decision-making. However, writing medical notes can also be time-consuming, tedious, and prone to errors. This blog post will cover everything you need to know about medical notes. We will also introduce you to Tali, an AI medical dictation and ambient scribe that can help you create accurate and comprehensive medical notes in minutes.

What Is A Medical Note?

A medical note is a written record of a patient’s health history, physical examination, diagnosis, treatment plan, progress, and outcomes. Medical notes are also known as clinical notes, progress notes, or chart notes. Medical notes serve several purposes, such as:

Providing evidence of patient care and clinical reasoning

Facilitating communication and coordination between healthcare providers

Supporting billing and reimbursement processes

Enhancing quality improvement and patient safety initiatives

Contributing to research and education

Medical notes are part of the patient's medical record, a legal document containing all the information related to the patient's health and care. They can follow different formats, such as the SOAP note.  The medical record may include other documents, such as laboratory reports, imaging studies, consent forms, prescriptions, referrals, and discharge summaries.

How To Write A Medical Note?

Writing a medical note can be challenging, especially when you must balance the competing demands of accuracy, completeness, brevity, and timeliness. Here are some general tips on how to write a good medical note:

Write the note immediately after seeing the patient or performing the procedure. This will help you avoid forgetting important details or relying on memory alone.

Use clear and concise language that is easy to understand by other healthcare providers. Avoid jargon, slang, abbreviations, or acronyms that may be unfamiliar or ambiguous to others.

Be objective and factual. Do not include opinions, speculations, or personal comments irrelevant to the patient's care. If you have any doubts or uncertainties about the diagnosis or treatment plan, state them explicitly and explain your rationale.

Be specific. Provide enough information to support your clinical judgment and decision-making. Include relevant data from history taking, physical examination, investigations, interventions, and outcomes. Quantify your findings whenever possible and use standard units of measurement.

Be consistent and organized. Follow a logical structure and format that makes it easy to find and follow the information in the note. Use headings, subheadings, bullet points, tables, or charts to present information in a structured way.

Be comprehensive but concise. Include all the essential information pertinent to the patient's care but avoid unnecessary or redundant information that does not add value or clarity to the note. Use short sentences and paragraphs that convey one idea at a time.

One of the most common formats for writing medical notes is the SOAP format, which stands for Subjective (what the patient says), Objective (what you observe or measure), Assessment (your diagnosis or impression), and Plan (your treatment or management). The SOAP format helps you organize your thoughts and systematically document your findings.

How To Format A Medical Note?

Formatting a medical note can vary depending on the type of note (e.g., admission note, progress note, discharge note), the specialty (e.g., internal medicine, surgery, psychiatry), the setting (e.g., hospital, clinic, home), and the preference of the healthcare provider or institution. However, some general principles apply to most medical notes:

Use correct spelling and grammar. Use a spell checker or a proofreading tool to check your note for errors before finalizing it.

Use punctuation marks (e.g., commas, periods, colons, semicolons) to separate sentences or clauses and improve readability.

Use headings or subheadings to label each section of the note (e.g., History of Present Illness, Physical Examination, Diagnosis, Treatment Plan).

Use indentation or alignment to create a visual hierarchy and separation between sections.

Use bullet points or numbered lists to present multiple items or options concisely.

Use tables or charts to display data or information in a structured way.

Use bold or italic fonts to emphasize important points or keywords.

If creating paper documentation:

Use a standard font size (e.g., 12 point) and style (e.g., Times New Roman) that is easy to read.

Use margins of at least 1 inch on all sides of the page.

Use single or double spacing between lines depending on your preference.

What Are The Common Abbreviations Used In Medical Notes?

When writing or typing, medical notes often use abbreviations to save time and space. However, abbreviations can also cause confusion or misunderstanding if they are not standardized or recognized by other healthcare providers. Therefore, knowing the meaning and context of the abbreviations used in medical notes is important.

There are many types of abbreviations used in medical notes, such as:

Abbreviations for medical terms, conditions, diseases, procedures, tests, or medications. For example, COPD stands for chronic obstructive pulmonary disease, ECG stands for electrocardiogram, and IV stands for intravenous.

Abbreviations for units of measurement, symbols, or signs. For example, g stands for gram, + stands for positive, and < stands for less than.

Abbreviations for directions, frequencies, or dosages. For example, a.c. stands for before meals, b.i.d. stands for twice daily, and i.m. stands for injection into a muscle.

Abbreviations for names of healthcare providers, institutions, or departments. For example, Dr stands for a doctor, NHS stands for National Health Service, and ED stands for emergency department.

There is no universal or approved list of abbreviations used in medical notes. Different specialties, settings, or countries may have different abbreviations or conventions. However, some common sources provide guidance or recommendations on the use of abbreviations in medical notes, such as:

The Joint Commission is an organization that accredits and certifies healthcare organizations and programs in the United States. It publishes a list of abbreviations that should not be used in medical notes because they are considered unsafe or error-prone.

The World Health Organization is an agency of the United Nations responsible for international public health. It publishes a list of abbreviations commonly used in health information systems and documents.

NHS Digital is an executive non-departmental public body of the Department of Health and Social Care in the United Kingdom. It publishes a list of abbreviations commonly used in the NHS App and other health records.

Are There Any Legal Requirements For Medical Notes?

Medical notes are legal documents that can be used as evidence in court cases, audits, investigations, or complaints. Therefore, medical notes must comply with the legal requirements and standards of the jurisdiction where they are created and stored. Some of the common legal requirements for medical notes are:

Accuracy : Medical notes must reflect the truth and reality of what happened during the patient encounter. They must not contain false, misleading, or inaccurate information that could harm the patient or the healthcare provider.

Completeness : Medical notes must include all the relevant and necessary information related to the patient's care. They must not omit significant details or facts that could affect the patient's outcome or the healthcare provider's liability.

Timeliness : Medical notes must be written immediately after seeing the patient or performing the procedure. They must not be delayed, backdated, or altered after the fact.

Legibility : Medical notes must be written clearly and readable so that other healthcare providers can understand. They must not be illegible, incomprehensible, or ambiguous.

Confidentiality : Medical notes must be kept in a secure and private place accessible only to authorized persons. They must not be disclosed, shared, or copied without the patient's consent or a valid legal reason.

How To Ensure Patient Privacy In Medical Notes?

Patient privacy is a fundamental right and a legal obligation for healthcare providers. Patient privacy means that patients have control over who can access their personal health information and how it can be used. Healthcare providers must respect and protect patient privacy by following the principles of confidentiality, consent, and security.

Confidentiality means that healthcare providers must not disclose or share patient information with anyone who is not involved in the patient’s care or who does not have a legitimate need to know. Healthcare providers must also ensure that patient information is not accidentally or intentionally leaked, lost, or stolen.

Consent means healthcare providers must obtain patient permission before collecting, using, or disclosing patient information. Consent can be expressed (e.g., written or verbal) or implied (e.g., inferred from the patient's actions or circumstances). Consent can also be withdrawn at any time by the patient.

Security means that healthcare providers must take reasonable steps to safeguard patient information from unauthorized access, use, modification, destruction, or disclosure. Security measures may include physical (e.g., locks, alarms), technical (e.g., passwords, encryption), and administrative (e.g., policies, procedures) controls.

Can Patients Access Their Medical Notes?

Patients can access their medical notes under certain conditions and limitations . Patients can request access to their medical notes from their healthcare provider or institution by following the established process and providing the required information. Patients may have to pay a fee to obtain copies of their medical notes.

Patients can access their medical notes for various reasons, such as:

To review their health history and progress

To verify the accuracy and completeness of their information

To share their information with other healthcare providers

To exercise their legal rights or pursue a claim

However, patients may not be able to access their medical notes in some situations, such as:

When the access would pose a serious threat to the patient’s health or safety

When the access would violate another person’s privacy or confidentiality

When the access would interfere with an ongoing investigation or legal proceeding

When access is prohibited by law or regulation

Can Medical Notes Be Shared Between Healthcare Providers?

Medical notes can be shared between healthcare providers involved in the patient's care or who have a legitimate need to know. Sharing medical notes can facilitate communication and coordination between healthcare providers and improve the quality and continuity of care for patients.

However, sharing medical notes also entails risks and responsibilities for healthcare providers. Healthcare providers must ensure they share medical notes only with authorized persons and for authorized purposes. Healthcare providers must also ensure that they share medical notes securely and appropriately, which respects patient privacy and confidentiality.

Some of the common methods of sharing medical notes between healthcare providers are:

Paper-based : Healthcare providers can print out copies of medical notes and send them by mail, fax, courier, or hand delivery. This method is simple and familiar but also slow and unreliable.

Electronic : Healthcare providers can use email, text, or instant messaging to send electronic copies of medical notes. This method is fast and convenient but also vulnerable to hacking, interception, or misuse.

Online : Healthcare providers can use online platforms, such as portals, networks, or cloud services, to upload, store, and share medical notes. This method is efficient and accessible but also dependent on internet connectivity, compatibility, and security.

Verbal : Healthcare providers can communicate medical notes verbally by phone, video call, or face-to-face conversation. This method is direct and personal but also prone to misunderstanding, distortion, or omission.

Medical notes are essential for providing quality patient care and ensuring legal compliance. However, writing medical notes can also be daunting and time-consuming for healthcare providers. We created Tali, an AI medical dictation and ambient scribe that can help you create accurate and comprehensive medical notes in minutes.

Tali is a smart and easy-to-use solution that captures the relevant information from your patient encounter and generates a structured and formatted medical note that follows the SOAP format. Tali saves you time and hassle by eliminating the need for typing, clicking, or scrolling.

With Tali, you can focus more on your patients and less on your paperwork. Tali helps you improve your productivity, efficiency, and satisfaction as a healthcare provider. Tali also helps you improve your patient outcomes, satisfaction, and loyalty by providing them with better care and communication.

If you want to experience the benefits of Tali for yourself, you can try it for free today .

Continue reading

Understanding and Implementing Medical Transcription: A Comprehensive Guide

Medical Dictation Software: A Complete Guide for Healthcare Professionals

A medical note is a comprehensive written record that documents a patient's health history, physical examination, diagnosis, treatment plan, progress, and outcomes. Often referred to as clinical notes, progress notes, or chart notes, medical notes serve various functions. They provide evidence of patient care and clinical reasoning, enable communication and collaboration among healthcare providers, aid in billing and reimbursement processes, enhance quality improvement and patient safety initiatives, and contribute to research and education. These notes are an integral part of a patient's medical record, which contains all information pertaining to their health and care, including documents like laboratory reports, imaging studies, prescriptions, and discharge summaries.

Writing effective medical notes can be challenging due to the need to balance accuracy, brevity, completeness, and timeliness. To achieve this, healthcare professionals should write the note shortly after interacting with the patient or conducting a procedure. Clear and concise language should be used to ensure easy understanding by other healthcare providers, avoiding jargon and abbreviations that may be unclear. Objectivity is key, meaning opinions or speculations irrelevant to the patient's care should be excluded. Specificity is also crucial; the note should include relevant information from history taking, physical examination, tests, interventions, and outcomes, quantifying findings where possible. Following a logical structure, such as the SOAP format (Subjective, Objective, Assessment, Plan), helps organize thoughts and systematically document findings.

Medical notes are legal documents that must adhere to the legal standards and regulations of the jurisdiction in which they are created and stored. These notes must be accurate, complete, timely, legible, and confidential. Patients' privacy rights must be respected and protected, ensuring that personal health information is not disclosed to unauthorized individuals. This is achieved through confidentiality, consent, and security measures. Healthcare providers must obtain patient consent before using or disclosing their information, and security measures, both physical and technical, must be in place to prevent unauthorized access or disclosure. Patients can typically access their own medical notes, though restrictions may apply in certain situations, such as when privacy, safety, or legal proceedings are at stake. Sharing medical notes among healthcare providers is permissible, but precautions must be taken to ensure security and proper authorization.

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How to Speak from Notes or a Manuscript in Public Speaking

Do you know how to move audiences, rather than just read your material? Here's how to speak from notes or a manuscript in public speaking.

Think it's difficult to read from notes or a manuscript and still relate to a public speaking audience?

It isn't, really. Why then do so many people do it badly? Keynote speaking, motivational speeches, pitching business, or contributing to a meeting are all examples of the same transaction: someone sharing important information, and others listening. Obviously, it can’t help to have a closer relationship with one's speaking notes than with the audience. But that's exactly what we see in too many presenters.

If you want to influence listeners, you must establish rapport with them. After all, are you persuaded by someone whose attention seems to be elsewhere when they're talking to you?

The words you say matter as well. Learn about the language that limits your success! Get my free white paper , "25 Words or Phrases to Avoid in Speeches and Presentations."

To be an effective presenter, then, you need to be able to gather your thoughts from a page, yet appear to be speaking without any notes at all. Below are six practical tips for doing so—that is, for performing effectively while using a manuscript, notes, PowerPoint , or other speaking aid. 

How to Be a More Dynamic Public Speaker

1. Write to Speak. Compose your talk for the ears —not the eyes—of your listeners. Aim for the rhythms of conversation rather than the more formal style of memos and reports or the barely-composed slang of e-mail. That means using simple words and short sentences. Use a tape recorder and listen to yourself to improve in this area. If it's inspiration you need, wrap your headphones around any speech by Winston Churchill. (Here are powerful techniques you can use to speak for leadership .) The idea is to make your words conversational, and therefore easy for you to access.

2. Make it Readable. Give yourself pages of typeface (or handwriting) that are easy to see from the lectern. Use a 16-point sans serif typeface like Arial, and triple-spacing. Avoid printing near the bottom of the page, or your audience will see the top of your head too often. When you finish a page, slide that page face up on top of the page that preceded it. It's less distracting for your audience than if you flip the pages over in the air.

3. Grab Key Phrases : You don’t want to spend more time with your text than with your listeners. So look down and “grab” a key phrase or idea. Then look up and say it. This is actually easier than it sounds. Practice it so you acquire a rhythm, an essential skill of public speaking. Remember this important rule: I f you’re not looking at your audience, nothing should be coming out of your mouth. Especially resist the temptation to look for what's coming next while you're still talking about the current point.

4. Use 'The Pause That Refreshes'. That’s a slogan from an old soft drink ad. But it applies equally well for you as a speaker, because you have to learn to use pauses! They help shape your speech. They show that you’re confident enough to let an idea sit still long enough to sink in. Pauses are refreshing for audiences. A speech without pauses seems to go on forever, regardless of its actual length. Combine this skill in pacing with these 5 key tools of vocal dynamics to be a more powerful speaker.

5. Make Eye Contact . This is the forest that many speakers don’t see because of the trees that made up the pages of their manuscript. Get in the habit of looking up from your speech with every sentence . Audiences need eye contact to believe you’re talking to them. So yes, eye contact is central to influence. Here's more advice on how to begin a presentation , especially in the critically important first 60 seconds.

6. Hit Your Peaks. Your speech needs shape in both ideas and delivery. A speech without a climax, for instance, is as formless as an amoeba; and presentations without vocal variety are sheer torture to the ear. The tendency of your voice to “flatten out” increases when you read from notes or a manuscript rather than actually talking to listeners. Audiences demand much more from a speaker than someone who just reads lines on a page. Your job is to breathe life into those words. Your listeners will love you for it, and wonder where you were if you don't.

Key takeaways from this blog:

• It's easy to read from a manuscript while still relating to your listeners.
• Compose your talk for the ears, not the eyes, of your listeners.
• If you're not looking at your audience, nothing should come out of your mouth.
• Despite nervousness, you must pause long enough for ideas to sink in.
• Breathe life into the words, and emphasize the high point of your speech. 

This article was originally published in 2015. It is updated here.

You should follow me on Twitter  here .

Tags: public speaking training , presentation skills , public speaking , effective presentations , public speaking tips , presentation tips , how to speak from notes or a manuscript , presentation training , motivational speaking , motivational speech , keynote speech , keynote speaker , public speaking rules , motivational speaker , rules for public speaking , keynote speaker training , motivational speaker training , keynote speaking

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How to write in the medical notes

• Related content
• Peer review
• Rachael Brock , clinical lead in national disease registration, Public Health England

What you need to know about good note taking

Medical notes are the backbone of patient care. Good notes facilitate communication between doctors, nurses, and all the allied health professionals involved in the care of the patient. They are a continuous, honest, and contemporaneous record of management and decision making—they help colleagues carry on where you left off. Medical notes are also useful for health professionals when defending a complaint or clinical negligence claim; they provide a window on the clinical judgment being exercised at the time. 1

As a foundation doctor, you’ll be responsible for much of the note taking on ward rounds and during multidisciplinary team meetings. It’s where you’ll document tasks that you have completed and any changes to patient conditions, or vital information from your on-call shifts. As a medical student your team might ask you to write in the notes under the supervision of a junior doctor. This article provides a guide on how to make notes that ensure joined-up care.

What are medical notes?

A patient’s notes consist of ward round notes, consultations—that is, visits from other specialties—results of investigations, and discussions with other professionals, patients, and relatives. Members of the multidisciplinary team such as nursing colleagues, physiotherapists, and occupational therapists also record their care in the notes. Some patients may move wards several times, and clear documentation helps with handovers.

You should follow good practice principles when taking notes. The General Medical Council says doctors should record their work “clearly, accurately, and legibly,” and it also stipulates that patient notes should be created contemporaneously and kept securely. 2 The notes may be scrutinised in medicolegal cases so remember the adage, “if it isn’t written down, it didn’t happen.” Below are guidelines from the GMC and the Royal College of Physicians (RCP) on the content of clinical records. …

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• Jun 26, 2021
• 18 min read

How to Give a Medical Talk: 7 Key Principles for Medical Students, Residents, and Rotators

Updated: Jun 4

Here’s the typical (and average) medical student talk

This is a re-creation of a talk that one of our students presented to the team last year. It followed the script for the typical medical student talk (ie the type of talk which we’ve sat through many times):

Introduction: “The subject of my talk is pulmonary embolism.”

Content: unrealistically extensive overview of a massive topic based on major texts

Conclusion: “Well, I guess that’s all I have.”

It’s easy to make that talk significantly more impressive and memorable

Introduction: “Substantial and unacceptable.” Those were the words of Dr. Kenneth Moser, referring to the morbidity and mortality rate of venous thromboembolism ... A major issue in reducing these high rates is enhancing early diagnosis. In my talk today, I’ll review recent advances in diagnostic techniques of pulmonary embolism.”

Content: in-depth review of a focused topic including recent medical literature

Conclusion: “As the recent literature has shown, the diagnosis of pulmonary embolism may clearly be challenging. As in the case of our patient Mr. Smith, however, a combination of diagnostic methods leads to improved sensitivity."

Being asked to give a talk on a rotation, observership, externship, or clerkship

May be anxiety-provoking, but it’s still a, great opportunity.

If you're a medical student, resident, observer, or rotator, then at some point during that experience you may be asked to give a medical talk or presentation.

This is a common (yet anxiety-provoking) experience. Having acknowledged that, it’s important to realize that preparing and presenting a talk is a great opportunity to demonstrate your knowledge and grasp of clinical issues. While you can’t control what an attending might ask during rounds, you do have complete control over your talk. With preparation and practice, you’ll be able to deliver an outstanding talk.

In this post, you’ll learn specific recommendations to improve the quality and impact of your talks.

In fact, it’s pretty straightforward to incorporate the 7 key principles of giving a medical talk.

It’s easy to make your medical talk significantly more impressive and memorable. These 7 key principles will show you how

1. Do the important prep work: audience research and topic choice

2. Strong introductions are critical

3. Educate, not overload

4. A strong delivery is vital

5. Practice the right way

6. Strong conclusions are also critical

7. "After the talk" is just as important as "during the talk"

If you're looking for more help applying to residency, we also offer our online course: The Residency Interview 101 . Our expert strategies and insider tips on the admissions process can help you become a standout applicant.

For medical school applicants, we also offer our Medical School Interviewing 101 course , which helps you quickly and confidently learn how to stand out in your medical school interview.

Principle #1 :

Do the important prep work:, audience research, time limits, and, choice of topic.

Before you sit down to draft your speech, make sure you do the important prep work.

Do an audience analysis

Know and adhere to all time limits

Choose the right topic: one that is focused, fits into time limits, and is of interest to you and your audience

You can’t give a talk unless you know your audience. Always take their knowledge level into account

If you’re assigned to speak before an unfamiliar audience, ask for this important information beforehand.

Your audience analysis should answer:

How many people will be in the audience?

How familiar is the audience with the subject?

What is the educational background of the audience?

How can I provide information relevant to their specialty?

What would I like the audience to do with the information I present?

If you consider the background of your audience, you’re more likely to deliver a talk that meets the needs of your listeners. In the article “Presenting with precision,” author Brenda Happell wrote that

“It is extremely frustrating to attend a presentation, confident that you are likely to learn something new, only to be exposed to basic information and knowledge that is readily available.”

Choose the correct topic

In some cases, you’ll be assigned a topic. If, however, you get to choose your own topic, we advise that you:

Choose a topic that you have background knowledge of. If you cared for a patient with asthma, address asthma.

Choose a topic that you’re interested in. Equally (perhaps more so), make sure it’s a topic that your audience is interested in.

Know your time limits

Once you know your time limits, make sure that you choose your topic accordingly. Time is a major concern, especially if you’ve been asked to speak about a broad topic such as “lung cancer”. To help you focus, either ask the attending for a specific aspect of that topic, or choose a relevant aspect, such as the therapy of metastatic lung cancer.

Many medical talks are too broadly focused

In a study of medical student talks, Yale students were asked to present a 30-minute talk on a topic of their choice during the Internal Medicine Clerkship. At the orientation, students were informed to avoid overviews or large topics. As an example, rather than talking about pneumonia, students were asked to focus on a particular aspect of pneumonia. Despite this recommendation, faculty evaluations noted that 35% of presentations were too broadly focused.

Clearly describe the objectives of your talk

You need to determine the specific purpose of your talk, also known as your lecture objectives.

What are the needs of your audience? Based on those needs, establish the objectives for your talk. When developing your objectives, be specific.

Consider these two possibilities:

"At the conclusion of this talk, my listeners will know how to manage an acute gout attack."

"At the conclusion of this talk, my listeners will be able to specify at least three types of medications that can be used to manage an acute gout attack."

The latter statement is clearly more specific and will help you develop a clear, focused, helpful talk.

Principle #2 :

Strong introductions are critical.

Start your talk with an introduction that leaves your audience eager to hear what else you have to say. You only have one chance to make a strong first impression. And if you fail to grab your audience’s attention, you’ll find it a challenge to capture it later.

For this reason, plan your introduction carefully. Too often, students begin their talk with one of these statements:

I’m talking today about …

The subject of my talk is …

Yes, it’s critical to include the topic and objective of your talk in the introduction. However, rather than using a bland statement, begin with an introduction that inspires interest.

Introduction Ideas: Ask a rhetorical question

We all realize that pulmonary embolism is a major cause of death. Did you know that the diagnosis of pulmonary embolism is missed in approximately 400,000 patients per year? And that's just in the United States ...

Introduction Ideas: Make a bold statement or share a startling statistic

In the United States, 650,000 people are diagnosed with pulmonary embolism every year, with over 200,000 deaths.

Introduction Ideas: Use a historical reference

160 years have passed since Virchow's classic paper on thrombosis and hemostasis was published and we, of course, continue to use the principles of Virchow's triad in the diagnosis and management of patients with pulmonary embolism. From historical reports, Virchow was small in stature but possessed a quick wit. He was known to be sarcastic, particularly when he dealt with incompetence or inattention. Yet he could also be generous and friendly, recognizing those who had made significant contributions. If he were alive today, he would perhaps be impressed with the progress that has been made in the diagnosis and management of pulmonary embolism, but he might also berate us for not making more progress. After all, pulmonary embolism remains a major cause of death in the United States ...

Introduction Ideas: Provide a thought-provoking quote

Substantial and unacceptable.” Those were the words of Dr. Kenneth Moser, referring to the morbidity and mortality rate of venous thromboembolism …

Introduction Ideas: Tell a brief story

If you've ever seen a patient die suddenly of a massive pulmonary embolism, it's not something that you will ever forget ...

Principle #3 :

Your goal is to educate, not overload.

Before you organize your talk, you have to first select material for your presentation. The real trick is determining what not to use.

Your research will yield more material than you could possibly use. This can actually be a problem: you need to avoid information overload, as there is a limit to what your audience can handle in a finite period of time.

In fact, one of the most common mistakes we see students make is presenting too much information. Remember: every point you make should support your talk's specific purpose. If it does not, cut it out.

Author Brenda Happell writes that “there is a tendency for inexperienced presenters to overdo the content in their presentation. It is easy to feel that every little piece of information is vital, but we know from experience that even the most interesting topic becomes hard to follow when we feel we are bombarded.”

How do you know what to include and what to discard? When you’re not sure, ask yourself if the information supports your specific lecture objectives. Discard any material that doesn’t support those objectives.

Make sure your data is accurate and that your resources reflect the most up-to-date science

During your talk, you’ll present data that supports your ideas. Your data must be accurate and relevant. Review all data several times, since even one inaccurate fact can call into question the accuracy of your entire talk. With statistics, make sure that your information is up-to-date. Presenting statistics that are years old when more recent information is available will damage your credibility. For resources, you should turn to authoritative texts as well as the recent medical literature.

Principle #4 :

Delivery is more than just content:, the importance of voice, body language, and note cards, do not, under any circumstances, read your talk word for word.

Some students write out their talk and then proceed to read it word for word. This is another very common error made by students. This almost always leads to a monotonous delivery. It’s also impossible to maintain eye contact with your audience, except for maybe an occasional upward glance, which diminishes credibility. Think about the best speakers at your medical school. How many of them read their talks word for word? Keep in mind the words of Dr. Michael Edwards who wrote that "... natural rhythm of telling a story with its pauses and eye-to-eye contact with the audience is lost when the talk is read."

Feel free to use note cards

Instead of reading your talk, we recommend the use of note cards, with no more than ten words (or so) on each card. These should be a reminder of the most important points. As you’re speaking, you then formulate sentences to express these points.

Practice with these note cards. As you practice, you’ll be able to start developing sentences using just these few words as cues.

As you grow less dependent on your cards, you can then memorize your introduction. Especially with a memorized introduction, you can convey the impression of confident and articulate student right from the start.

On the other hand, when quoting an article or conveying detailed statistics, it’s better to refer to your notes.

Avoid-the-monotone

Students sometimes present an entire talk in the same pitch and pace, leading to the dreaded monotone. This is boring, and it suggests a lack of interest in the topic. As you practice, work to incorporate a more natural pitch and pace throughout your speech.

Limit your use of fillers

Fillers are sounds like “um” and “er” that speakers often use when they’re thinking about what to say next. Most students don't even realize that they use fillers. Make sure you record yourself, and if you find that you’re relying on them too much, practice replacing them with short pauses.

Speak at the proper pace

You need to speak at a speed that allows your audience to follow.

In students who normally speak at a reasonable pace, anxiety can cause them to speed up. The effect is poor enunciation with mumbled words and sentences. "Too many ideas presented too quickly will not be understood, even to the most well-informed and intelligent audience."

You must make a conscious effort to slow down so that your listeners can follow you. Accomplished speakers will also pause periodically to allow their listeners to fully process.

In their article on lecturing, Brown and Manogue wrote that lecturers, to improve clarity, should "speak clearly, use pauses, and don't go too fast ... Whilst these suggestions may seem [to make] common sense, observation of lectures suggest that they are not common practice."

Utilize gestures appropriately and deliver the talk while standing, if at all possible

Only 7% of a speaker's message is felt to be obtained through actual spoken words. 55% is conveyed through nonverbal communication, while 38% is transmitted through vocal tone.

How does this come into play if you’re speaking in a small conference room? Students often remain seated during talks given to a small group, and we’ve found that they generally place their hands underneath the table. This robs them of the ability to gesture. Voice patterns often follow hand movements, which may affect the energy of your presentation.

If at all possible, give your talk while standing. Keep your hands in front of your body with your palms open, and feel free to gesture when appropriate. If you decide to give your talk while seated, lean forward in your chair, a gesture that conveys enthusiasm and confidence.

Avoid gestures that convey anxiety or a lack of confidence

These include:

Keeping your hands in your pockets

Gripping the lectern or audiovisual equipment

Playing with keys or coins in your pocket

Rocking back and forth or from side to side

Rubbing the back of your neck

Playing with your hair

Clenching your fists

Pacing back and forth

Fidgeting with clothes or jewelry

Do you make any of these gestures? Most students have no idea they’re doing any of these. That’s why we recommend that you record yourself.

Eye contact is a critical component of delivery

As you give your talk, make eye contact with your listeners. This keeps audience members interested, and helps you come across as more credible and confident.

One technique is to speak to one audience member, then direct your attention to another audience member. We recognize, however, that looking into people’s eyes while delivering a talk can be difficult for some students. If you find this unnerving, focus on another part of the face such as the forehead, nose, or mouth. Your listeners won’t know the difference.

As you make eye contact, don’t be surprised if someone in your audience isn’t paying attention. You may notice your audience nodding off, as your audience, sadly but expectedly in a medical setting, is often a very tired group. (As a speaker, I can tell you that chances are very high that somebody in your audience will start to nod off.)

Don't be thrown off track if a phone goes off or if audience members are engaging in conversation. (These are very common. Let me repeat that. VERY common.) As distracting as any of these may be, they shouldn’t be allowed to affect your presentation.

Pay attention to audience feedback during your talk

It’s very easy to be overwhelmed by the task of providing great content and ensuring an effective delivery. Most students are single-mindedly focused on giving a great presentation.

However, you need to be alert to audience feedback. During a presentation, this takes the form of nonverbal cues, such as body language cues that indicate total boredom.

While it’s easier to process such feedback when you’re an experienced speaker, such cues should be a warning sign. You may need to work on eye contact, or vary your volume, pitch, or pace of delivery.

Visual aids enhance presentations

Studies on learning styles have clearly identified distinct preferences. Some individuals are visual learners, while others describe themselves as aural learners.

Some learn better by seeing, others by hearing--but a talk that meets the needs of both learning styles will have the most impact. Whenever possible, try to incorporate visual aids.

Obviously, there are situations where this won’t be possible. If the attending has asked you to give a quick 2-minute "blurb" on a topic while standing in the hallway between patient rooms, the short duration and location of the talk clearly preclude the use of visual aids.

For longer talks that take place in an environment more conducive to the use of visual aids, there are compelling reasons to do so. Effective use of audiovisual aids can:

reinforce your statements

help you direct the audience’s attention

help your audience comprehend your ideas

make you appear more credible and professional

lead you to deliver a more memorable talk

Students today most often use PowerPoint or a similar tool. While these are useful, this only holds true when utilized well. Poor visual aids can actually downgrade the effectiveness of your talk.

PowerPoint Do’s and Don'ts

Don't read the text.

Do use a font color that contrasts with the background color.

Do use the same background color throughout the presentation (medium blue is popular).

Do maintain consistency by using the same symbols and typefaces.

Don't use full sentences. A good rule is to keep each line no more than 6-7 words.

Don't place too many points on each slide (less is more).

Do use at least 18-font size (be sure that people in the back row can read the information).

Make sure you avoid fancy fonts. Instead, choose a standard font like Arial or Times New Roman.

Don't capitalize entire words unless necessary.

Do proofread your text for spelling, repeated words, and grammatical errors.

Make sure you avoid overly complex tables, charts, graphs, or diagrams.

If possible and the topic lends itself to this, provide a short handout

Should you provide your audience with a handout? In many cases, yes. Handouts can help the audience follow your train of thought.

Most listeners appreciate written material that they can refer to later. The fact that you produced a handout will also give your audience some idea of the effort you put into the talk.

As you prepare the handout, pay careful attention to its presentation. Its appearance is a reflection of you. If it appears unprofessional, your listeners may form a negative impression, even before you’ve opened your mouth. As always, proofread your work to avoid misspelled words and grammatical errors.

You can provide the audience with the handout either before or after your talk. The disadvantage of handing it out at the start is that your listeners may pay more attention to the handout than to you. With complex subjects, however, you may find it preferable to have the audience follow your thought process.

Principle #5 :

There is actually a right and a wrong way to practice.

When practicing, strive to simulate the actual experience as closely as you can. Whenever possible, practice in the room in which you’ll actually be speaking.

If this isn’t possible, pick a room that closely resembles the real location of your talk. Doing so allows you the opportunity to become comfortable with the environment.

As you practice, don’t just go over your talk in your head. There is a difference between thinking and speaking.

Do this instead:

1. Stand in the proper spot of where you will be presenting

2. Imagine an audience in front of you

3. Rehearse your talk.

4. Use your notes exactly as you plan to during the actual talk. If you’ll be using audiovisual equipment, practice with the equipment.

5. As you rehearse your talk, time yourself to ensure that your presentation fits within the allotted time. If you run over, delete material instead of just speeding up.

You can learn a lot by videotaping yourself

This is a valuable yet underutilized way of improving performance. Play it back so that you can see and hear yourself the way that your audience will.

We’ve found that students are often surprised by what they learn from a videotape of their performance.

Utilize the techniques of professional speakers to handle anxiety

Some surveys have demonstrated that public speaking is the number one fear, ranked ahead of the fear of death. Anxiety affects everyone, but the best speakers are able to channel that nervous energy into a better performance.

If you do experience anxiety, you may find it reassuring that studies have shown that speakers generally report a higher level of anxiety than what an audience can perceive.13 In other words, audiences aren’t very accurate in detecting a speaker’s level of anxiety.

Before the presentation:

1. Take several deep breaths

2. Stand tall

3. Make eye contact with your audience

Ways to relieve anxiety before giving a talk

Adjust your attitude

Students who view their talk as a task to avoid may develop greater anxiety than those who see it as an opportunity to improve skills in communication.

Ensure adequate preparation and practice

The best way to lessen speech anxiety is to give yourself sufficient time to prepare and practice the talk.

Don’t overestimate the talk’s importance

A talk typically accounts for only a small percentage of the clerkship grade.

Use positive self-talk

“I know my topic, have prepared well for the presentation, and am confident that it will go well.”

Visualize success

Athletes and actors, as well as public speakers, use the techniques of visualization. Visualize yourself, with full detail, delivering a well-received presentation

Principle #6 :

Strong conclusions are also critical.

Some students conclude their talk with “I guess that’s about all I have,” or “I think I’ve gone over everything.” These statements completely lack impact.

Some of my students have even closed with an apology. “I’m sorry I wasn’t able to find more,” “I’m sorry I couldn’t get the projector to work,” or “I’m sorry the talk went so long”.

In ending your talk, do not mumble and do not ever apologize. The conclusion is also no place for bringing up new points or rambling on and on. Students who don’t take the time to think about their conclusion end up closing with a whimper rather than a bang.

To conclude in a way that leaves the audience with a lasting, powerful impression, begin with a phrase that tells your audience that you are wrapping up your talk.

Examples include:

In concluding, I want to …

Let me leave you with …

As a final thought …

To wrap up my talk ...

Since most of your talks will be informative presentations, close by briefly summarizing your main points.

After doing so, end your speech with an interesting closer, perhaps a quote or rhetorical question.

Since a talk is often assigned when a team member raises an issue pertaining to a patient, one effective way to conclude is to apply your information to that specific issue.

“As the recent literature has shown, the diagnosis of pulmonary embolism may clearly be challenging. As in the case of Mr. Smith, however, a combination of diagnostic methods leads to improved sensitivity."

One final note: to leave your audience with a strong, final impression, avoid reading your conclusion. Instead, know it well enough that you can deliver the conclusion with few, if any, notes.

Principle #7 :

After the talk is just as important as during the talk:, prepare for audience questions and seek audience feedback, don’t be afraid to say “i don’t know.”.

At the conclusion of your talk, you should invite questions from your listeners. While few students end their talk with such a statement, it is important to do so. I’ve found that many students would rather avoid questions, because they fear they won't know the answer. This is natural, and is certainly a concern for experienced speakers as well.

However, experienced speakers will prepare for the question and answer period by anticipating questions. They then proceed to develop responses to these questions, providing for more polished replies. You can do the same.

You can begin the question and answer period of your talk by simply asking the audience, “Do you have any questions?” When asked a question in front of a large group, you should rephrase the question before answering it.

“Can you clarify the research methods used in the study on statins and inflammation?” “Certainly. The question refers to the research methods used in the study on statins and inflammation. In this particular study…”

This technique ensures that everyone has heard the question and also provides additional time to formulate an answer.

While you are expected to be well read about the subject of your talk, you are not expected to have all the answers. If you’re asked a question and you don’t have an answer, you can simply say “I don’t know, but I will find out.”

Another option is to defer the question to your attending. “Dr. Chen, in your experience with pulmonary embolism, how would you handle this situation?” Avoid at all costs an attempt to bluff or to provide inaccurate information.

Tips for answering questions at the end of a talk:

Let your listeners know early in the talk when you plan to answer questions

Encourage questions by asking "Do you have any questions?"

Listen carefully to the question to make sure you understand it

Make eye contact with the questioner while the question is being asked.

Repeat the question, especially in a large group, to make sure that it’s been heard.

Make eye contact with the audience as you answer

If you don't know the answer, don't bluff or lie. You also don’t need to apologize.

Consider deferring the question to an expert, if one is in the room

Feedback, feedback, feedback

Hopefully, team members will offer you specific feedback after your talk. However, most feedback tends to be vague and short on the specifics that you need to improve your performance during future talks. To make the most of this experience, you must solicit specific feedback.

Examples of questions you might ask (and only at the appropriate time and if it seems appropriate to ask that individual):

Was the introduction interesting?

Was the topic and purpose of my talk clear?

Did you feel that I made eye contact throughout the talk?

Was I able to maintain your interest?

Was the talk well-organized

Do you have any other suggestions for improvement?

Take team members’ suggestions seriously, and determine how you will use this information to improve future talks.

The corollary to these 7 key principles:

Be the first to volunteer to give the talk.

During attending rounds, sometimes an attending will turn to the team and ask “Who wants to give us a talk about this subject?”

If you’ve ever been in this situation, you know what usually happens next. Team members try to avoid the attending's gaze, and silence falls. Although this is a common reaction, it’s certainly not ideal.

Instead, if the attending asks, be the first person to volunteer. This is an opportunity to stand out and demonstrate your enthusiasm and initiative.

The bottom line: Yes, it can be nerve-wracking to just think about giving a medical talk. But with the right tactics and practice, you can absolutely excel.

Dr. Rajani Katta is the creator of Medical School Interviewing 101 , the course that teaches students how to ace their interviews. She is also the author of the best-selling books The Medical School Interview: Winning Strategies from Admissions Faculty and the Multiple Mini Interview (MMI) . She served as Professor of Dermatology at the Baylor College of Medicine for over 17 years.

Dr. Samir Desai is the creator of The Residency Interview 101 and the author of 21 books, including The Successful Match: Rules to Succeed in the Residency Match . He has served on the medical school admissions and residency selection committees at the Baylor College of Medicine and Northwestern University Feinberg School of Medicine.

For a free excerpt of The Successful Match, sign up here .

For a free excerpt of the medical school interview, and the mmi, sign up here ..

• Success in Medicine

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How Are We Today? Study Lets Patients Help Write Medical Notes, Google Doc Style

• Carey Goldberg

First, beginning about five years ago, came the OpenNotes study. Researchers found that when they gave patients access to their primary care doctors' written notes, the patients said they got better at taking care of themselves, particularly at taking medications correctly. And contrary to some doctors' fears, the notes did not tend to cause offense or avalanches of questions.

"OpenNotes" caught on; Some 5 million patients' records around the country now use it.

Then came the next bold move: The researchers, centered at Beth Israel Deaconess Medical Center, launched a pilot program to open some psychiatric notes to selected patients. (The journal headline: Let's Show Patients Their Mental Health Records . Our headline: What Your Shrink Thinks .)

And now, the open records movement is moving beyond transparent, to interactive. That is, what if you could not just see your doctor's medical notes but actually comment on them and contribute to them? As you do, say, when you collaborate online with colleagues on a project in Google Docs?

That's the next step, says Jan Walker, co-director of the "OpenNotes" project and a researcher at Beth Israel Deaconess and Harvard Medical School. With a new $450,000 grant from The Commonwealth Fund, researchers plan to develop and test "OurNotes," an interface that will invite patients to contribute to their own medical notes.

Our conversation, edited:

Given the self-obsessive behavior of some people I know who use Fitbits and other health trackers, I think if I were a doctor I'd fear a huge deluge of data into my patients' health records: "I took 6,000 steps and slept 6:27 hours..." How do you address that? Jan Walker: One of the frontiers here is making decisions about what data is really paid attention to. As we invite patients to contribute to their records, as we invite patients to upload data from home devices into their records, there are going to be many new inputs of data into the medical records, from technologies that probably don’t even exist yet.

For clinicians, this can look like such a flood of data coming toward them that it’s impossible to pay attention to, to distill it and act on it, and be responsible for understanding everything that's coming in. So one of the interesting parts of this research is figuring out how to highlight important things for clinicians, and let the rest just be stored.

We will face some of that with this project; perhaps we will be able to have patients flag things they think are important for doctors to see right away, versus just things that are reminders to themselves or things they want to have in the documents.

So will it be kind of like editing with someone on a Google doc, where you can see who did what?

We don't know yet but we're thinking about things exactly like that.

What are some examples of uses you imagine?

If you’re a patient, you might have gone to the doctor with an infection and been given antibiotics. So you might write down in this record when your symptoms abated or how you did with the antibiotics.

Similarly, you might read in your notes that the doctor reminded you to exercise, and you might keep track of your exercise regime to discuss that with your doctor at the next visit.

Or, in between visits, you may think of things that you want to talk to your doctor about on the next visit, and you would, in essence, set an agenda for yourself so that when you get to that visit, everything gets covered.

And the doctor could look at your agenda beforehand and be more informed, instead of looking things up on the fly?

Exactly. If you can set an agenda before you get to the visit, it gives the doctor a chance to prepare.

Another possibility would be to work with the clinician actually during the visit to write this note. Perhaps the clinician starts the note while you are still sitting there in the office, and you look at what’s being written, you comment, you add, and so it becomes almost a co-authored note.

Yet another use of this interactive feature would be to raise questions about things you think might possibly be in error.

If you notice that something was recorded inaccurately or you think it's not quite right, this would be a way to raise that and perhaps get it corrected in the medical record. So it could play potentially an important part in increasing patient safety. In fact we’re already experimenting with this at Beth Israel Deaconess Medical Center, where patients can report questions about safety concerns, in a small pilot.

So how would this be different from just reading your medical notes and emailing your doctor?

Today, a lot of patients have the capability of emailing their doctors, nurses and others using secure messaging within provider portals. Patients are pretty careful about not emailing their clinicians unless they think it's really important. OurNotes will complement that capability, by enabling patients to almost keep a diary for themselves, of things to remind themselves about that are not urgent. Eventually, I think the lines between emailing the doctor and writing messages in the notes themselves may actually blur.

So what's the state of play of the new OurNotes project?

It will start as a small pilot at Beth Israel Deaconess Medical Center in Boston, at Geisinger Health System in rural Pennsylvania and at Harborview, a safety net hospital in Seattle, and also at Group Health in Seattle and Heartland Health in St. Joseph, Missouri.

We have different medical record systems and we will develop different approaches to inviting patients to contribute to these notes, and the intent is to see what works and what doesn't work. And then, hopefully, when we have learned about that we will undertake a larger study with a larger population.

In the bigger picture, would you say this is the shape of the future of medical records or patient engagement?

This is really the next stage of development for medical records, we think. Historically, clinicians have written notes and locked them up. In fairly recent history, patients have gotten permission to have copies, have access to those records, but it has been very much the province of clinicians to write and keep and document what's going on. But in order to take care of themselves, patients really need the information that is in those records. OurNotes will invite patients to be active rather than passive participants in care.

Readers, thoughts? Reactions?

Tangentially related: Teaching In the Cloud: How Google Docs Are Revolutionizing The Classroom

Carey Goldberg Editor, CommonHealth Carey Goldberg is the editor of WBUR's CommonHealth section.

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General Aphasia 27-09-2022

Tips for Communicating During Medical Appointments

Visits to the doctor sometimes involve difficult words, such as medical jargon, and you may feel hurried in your communication if the appointment seems rushed. We asked you for your best tips for communicating during medical appointments. These are the great thoughts people suggested.

Prepare Information at Home

Walter not only has a great suggestion, but he also provides a downloadable sheet . He says, “I have a sheet with my name, DOB, phone number, address, wife and phone number, other doctors, drugstore, morning meds, and evening meds.” Now you can, too .

Write It Down

By writing down questions beforehand, you can prioritize the ones that you need to cover in the appointment. Elizabeth suggests, “Be prepared with a written script on a notepad — easy to read — on how you are doing. Limit it to key questions.”

It also gives you a chance to look up information ahead of time. Paul shares, “Research beforehand. Write down the questions and then practice them.” Tim echoes that idea: “Write it down before you go. Use notes on your phone ahead of time so you will be prepared.”

Guide the Conversation

Sometimes you need to prompt the other person to make a conversation aphasia-friendly. Start by bringing up aphasia with the intake nurse or other staff. Boyd suggests using aphasia as a starting point when the doctor enters the room: “Tell the doctor, ‘I have aphasia’.” Cynthia cautions not to take it for granted that medical staff will know about aphasia:

Go ahead and tell them you have aphasia. In my case, I also let them know that I am a stroke survivor because most people don’t know how to recognize aphasia. Yes, even in a doctor’s office, the people who answer the phone sometimes!

Trazana also suggests asking doctors to “repeat or ask for information in a written form of communication.” In other words, help them be aphasia-friendly by making suggestions that will help you.

Take Someone With You

You may have noticed that many doctors today bring a notetaking assistant to the appointment. You can, too! Theresa suggests bringing a “caregiver spokesperson,” if you’re worried about communication. Even if you feel confident, it always helps to have a second pair of ears listen to the information. Seth states:

Bring someone to take notes and show you during the meeting, if helpful. Also, if comfortable, try to educate the doctor about aphasia and your need for an accommodation to communicate.

Bruce informs us what he does when he goes alone:

I bring a notepad with questions and a Sony Voice recorder so I can record the meeting with the doctor, Then I can play back the recording with my wife later.

It’s a great device if you don’t want to have to find the recording app on your phone.

Use Pictures

Aphasia-friendly communication means using every communication tool at your disposal, including pictures. Brooke suggests keeping a “photo on your phone with your medications.” Doreen also uses pictures: “List your concerns ahead of the appointment. Use pictures, google searches, and print information. Bring all medical records. (You can keep them on your phone, too!).”

We hope these help your next appointment go smoothly .

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The 5 Best Speech-to-Text Solutions For Medical Notes

Still taking down notes like it’s 1997? No bueno! We're spilling the beans on the top 5 speech-to-text solutions that'll save you time and headaches when documenting patient visits.

In this article, we’ll cover: 

• The basics of speech-to-text medical notes
• What you should look for in a note-taking app
• What are the top 5 text-to-speech medical notes apps?

Time to get started! 

What are speech-to-text medical notes?

Speech-to-text medical notes refer to the transcription of spoken words into written text within the medical field.  

What makes this process possible? AI and speech recognition technology , which captures and converts healthcare professionals' verbal dictations into a digital text format. 

These notes can include:

• Patient consultations
• Medical histories
• Examination findings
• Cooperative reports
• Other clinical documentation

Speech recognition solutions for the exam room can save doctors boatloads of time . Instead of typing the day away, you just talk and the software types for you.

Also, some systems hook right into your EHR , automatically transcribing your golden words into perfect notes. Others work as standalone dictation tools, giving you text you can easily copy and paste. 

The best part? These smart-systems actually understand medical lingo , so you can rattle off anatomy, conditions, and procedures without missing a beat.

What should you look for in speech-to-text medical notes?

So you want to ditch the keyboard and start dictating your notes ? We don't blame you!

Before you get started, though, take a look at these must-haves:

• The last thing you need is a transcription full of "Tyler Knoll". Look for a solution with advanced speech recognition that's been trained in medical terminology. Precision is key, doc!
• If the interface isn't intuitive, you'll be fighting the tech instead of focusing on your patients. Find one that fits seamlessly into your workflow.
• Patient privacy should be top of mind. Choose a solution with robust data protection and HIPAA compliance. You don't want sensitive info ending up where it shouldn't!
• Every practice has different needs. Look for a solution that lets you customize templates, vocabularies, and more. The more tailored, the better.
• Why toggle between apps when you can have one that syncs directly to your EHR? Find a speech-to-text solution that integrates fully so you can save time and avoid redundancy.

What are the top 5 speech-to-text apps for medical notes?

The good news is there are a ton of speech recognition options for clinicians nowadays. The bad news? Some aren’t as helpful as they should be.

To save you the hassle of testing out duds, here are our top picks for speech-to-text medical solutions:

Lindy takes the gold medal. It’s AI tech that listens, understands, transcribes, and perfectly streamlines every part of the note-taking workflow. 

• Spot-on speech recognition: Jumps into action with a 99% success rate in picking up specialized medical vocab right from the start.
• Direct EHR feed: Smoothly funnels transcribed notes into EHRs, slashing the usual wait and redo times by smartly pulling data across the EHR for note completion.
• Plays well with others: Effortlessly meshes with leading EHR systems like Epic, and indispensable tools including email, Google, and Zoom.
• Instant charting insights: Generates on-the-fly suggestions from the dialogue and existing patient info, with the ball in your court to approve or skip.
• Adaptive learning curve: Gets sharper with each use, customizing its grasp on your dialect, medical shorthand, and field-specific lingo for tighter accuracy.
• Forward-thinking task prep: Anticipates and sets up everyday tasks in advance, simply waiting for your say-so to roll them out.
• Intuitive task alerts: Keeps you in the loop with essential follow-ups such as tests and referrals, pinpointed from the documented notes.
• Uncompromised data security: Upholds top-tier HIPAA compliance.

DeepScribe's 98% accurate transcription nets it a silver medal. 

It understands accents, whispers, and medical jargon , learning from your edits for continuous improvement.

• 98% accurate transcription: Don’t you hate it when transcription programs garble what you say? DeepScribe captures every word with near-perfect accuracy.
• Customized notes: Adapt notes on the fly, adding, deleting, or editing as needed. DeepScribe learns from your preferences for continuous improvement.
• Real-time insights: Gain valuable understanding during patient visits with live notes and searchable transcripts. Stay on top of key elements throughout the encounter.
• Seamless EHR integration: DeepScribe helps you save hours of admin work by directly uploading finished notes to your existing EHR system. 
• HIPAA compliance: DeepScribe sticks to strict HIPAA regulations to ensure data security.
• Great at understanding medical lingo: Fluent in Jargonese, DeepScribe confidently identifies and captures over 400 common medical terms for comprehensive documentation.

Suki accurately transcribes even the most complex medical terminology, simplifies coding, and offers real-time term suggestions for (virtually) guaranteed precision.

• Totally hands-free: Suki lets you transcribe patient interactions effortlessly. 
• Jargon buster: Suki accurately transcribes even challenging conversations, including jargon and difficult speech.
• Coding made simple: Simplify the coding process with Suki's intuitive features.
• Contextual understanding: Suki's advanced understanding captures the nuances of your conversations, helping you get deeper insights from each consultation.
• Excellent precision: Suki’s accuracy with real-time medical term suggestions during conversations helps you not miss a beat. 
• Personalized assistant: Suki helps you tailor your experience with customizable templates –- and the ability to ask questions for personalized support.
• Big time-saver: Save up to 72% of your time, freeing you to focus on patient care and other priorities – a huge efficacy boost. 
• Secure integration: Kick back with the knowledge that you’ll have secure integration into leading EHR/EMR platforms like Epic and Cerner. 

Odin's AI-powered medical documentation system provides transcription, real-time summaries, automatic SOAP note creation, and, of course, seamless EHR integration. 

• Accurate medical transcription: Odin understands everything, capturing details even in complex (noisy) consultations. 
• Real-time insights for clinical focus: Odin generates live summaries, flagging key elements and action items, and you don’t have to lift a finger. 
• Automated SOAP note creation: Streamline documentation with automatic SOAP note generation tailored to your specific practice and preferences.
• Seamless EHR integration: Odin plays nice with your chosen EHR system for effortless note upload and data synchronization.
• HIPAA compliance: You can trust Odin to protect sensitive patient information with industry-leading security measures and strict adherence to HIPAA regulations.
• Customizable terminology recognition: Train Odin to recognize your specific medical terminology and abbreviations for personalized accuracy.
• Research & audit assistant: Quickly search transcripts for keywords or revisit specific patient encounters for insightful analysis.
• Remote patient monitoring: Transcribe and analyze telehealth consultations with the same accuracy and efficiency as in-person visits.

Now, for a little palate cleanser. What sets ScribeWell apart? Their 99% accuracy, provided by human medical scribes. 

• Highly qualified scribes: Work with a team of expert transcriptionists who nail every detail with precision.
• Medical terminology experts: Count on their deep understanding of complex medical lingo for spot-on transcriptions.
• HIPAA compliance guaranteed: You know the drill, and they know it too.
• Get personalized support from your own account manager: Pick the ordering option that suits you, and enjoy quick turnaround times for your documents.
• Customization for your practice: Use speciality-specific templates, customize medical terms, and rely on thorough quality checks to keep your transcripts accurate.
• Benefit from detailed training, responsive customer service, and regular account optimization for continuous improvement.
• Enjoy the accuracy and consistency that come from expert reviews, power up physician efficiency by reducing admin load, and improve patient satisfaction with clear, comprehensive documentation.

Do I have to speak clearly and slowly? 

Nope, these AI systems are smart enough to understand natural speech . Just talk at your normal pace and volume.

Will it understand my accent? 

Speech recognition technology has gotten really good at handling different accents and dialects. As long as you’re speaking clearly in English, it should have no problem understanding your unique way of talking.

What if I stutter or stumble over my words?

No need to be self-conscious, the software won’t judge you! It’s designed to interpret human speech, stutters and all. Just correct yourself and keep going.

Do I have to use certain words or phrases?

You can speak freely using your own words and style. The system will analyze the context to determine the appropriate medical terms to include in your notes.

What if I want to edit or revise something? 

No problem, you can easily review, edit, and revise the transcribed notes. The software will continue learning from any changes you make to improve over time.

Is speech-to-text technology secure enough for sensitive medical information?

Absolutely. Leading speech-to-text platforms prioritize security, employing robust encryption and compliance protocols, including HIPAA, to protect patient data and ensure confidentiality.

How does speech-to-text technology integrate with existing EHR systems? 

Top-tier speech-to-text tools offer seamless integration capabilities , which lets them play well with most EHR systems, making the documentation process a breeze – and not messing up your existing workflow.

Can speech-to-text software recognize medical terminology? 

Of course! High-end speech-to-text systems are specifically trained on medical vocabs, allowing them to recognize and accurately transcribe a broad spectrum of medical terms, from common jargon to super-specialized phrases. 

We just went over the 5 best speech-to-text solutions for taking medical notes. Now, it’s time to ditch the pen and paper and bring your medical practice into the 21st century.

Explore AI-powered, HIPAA-compliant Medical Dictation with Lindy

Your AI Medical Scribe.

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5 reasons to dictate clinical notes during patient visits

Do you ever wish you could spend less time charting or documenting patient care in the EHR? This article will help you choose the correct medical dictation workflow and understand why some physicians dictate clinical notes in the presence of their patients.

Mobile medical dictation creates new possibilities

Dictation is easier than ever in the digital era. Gone are the days of waiting hours to receive transcriptions and close charts. Using modern voice recognition software , you can speak into your smartphone and have your words appear instantly in the patient chart. 

So why do many physicians still type notes?

Dictation is the obvious best choice from an efficiency perspective. Basic math reveals that dictating clinical notes is faster than typing them . But as a physician, efficiency isn’t the only variable important to you. You want to provide excellent care, connect with your patients, and keep a profitable practice. Making dictation work for you requires finding the correct workflow.

Mobile medical dictation creates new possibilities for how, where, and when you dictate. Using the latest speech recognition software , you can use your smartphone as a universal dictaphone that instantly transcribes your words into any text field on any computer. You can even create dictations on the go, which remain securely stored on your mobile device for later transfer into the EMR. 

When doctors can dictate anywhere – at home, at the office, or on the commute – why dictate during patient visits?

Five reasons to dictate clinical notes in the presence of your patients

Dictation has lots of benefits as a way of capturing clinical data. But many argue that moving this documentation process to the exam room creates additional value for patients and providers. 

There are at least five good reasons to adopt a documentation workflow that includes dictating in the presence of your patients. 

1. More efficient documentation

Because we speak faster than we type , dictating in the exam room reduces the time spent recording care. Most doctors type around 30 words per minute (WPM), while the average conversation rate for English speakers is about 150 WPM. Even accounting for pauses for dictation commands, careful word choice, and reflection, dictating is the fastest option.

You can save even more time by incorporating dictation into the patient visit. For example, rather than repeating care instructions to ensure the patient understands, begin dictating while recounting pertinent highlights. In this way, patient communication doubles as documentation time.

2. Higher quality care

Most family physicians see about 20 patients daily and have to document a massive amount of information about each visit. If you delay documentation to later in the workday or late-night charting, it can be hard to remember all the details.

By dictating during each visit, you capture essential information while the details remain fresh. By speaking this information, you also review it with the patient, who can correct any errors or add important information. 

This collaborative approach involves the patient in a way that can improve compliance and, ultimately, the quality of care.

3. Improved patient satisfaction

Patient-present dictation can have the added benefit of improving the patient experience. Patients want to feel heard and understood, and by repeating your diagnosis and treatment plan in their presence, you demonstrate that you clearly understand their condition.

Of course, you should tell the patient what you’re doing, as with any other procedure. For example, you might say, “I’m going to dictate a few notes into your medical record to ensure we get everything right.”

As of 2021, a new federal rule requires that all providers give patients access to clinical notes , which means that your patients can read your notes anyway. By dictating your notes during the visit, you ensure that any confusion or disagreement is taken care of upfront. 

4. Foolproof malpractice protection

Doctors who document visits in the patient’s presence may be unwittingly reducing their risk of malpractice claims. Reviewing notes with patients ensures that records are contemporaneous, patient-witnessed, and patient-approved. Charts are more likely to be complete and accurate when you invite patients to amend or correct the information as you document. 

Some physicians who use this method include the phrase “dictated in the presence of the patient” in their notes. This inclusion provides powerful protection in case of any dispute. 

Research also shows that, for primary care physicians, communication practices are associated with malpractice claims . 

Communication behaviors associated with fewer malpractice claims include:

• statements of orientation (educating patients about what to expect and the flow of a visit),
• laughing and humor,
• and facilitation (soliciting patients’ opinions, checking their understanding, and encouraging patients to talk). 

Dictating during a visit creates numerous opportunities to practice effective clinical communication.

5. Better income 

A medical record that mirrors the entire patient encounter warrants a higher-level evaluation and management code than one that only captures the details you can recall from memory. By completing documentation in real-time with supplemental information from the patient, you’re more likely to produce a complete and accurate note, resulting in improved reimbursement. 

Also, consider the value of your time. If dictating during visits ultimately speeds up documentation by 10-20%, that time savings equates to thousands of dollars a month. Even a small investment in mastering a new dictation workflow can pay substantial returns over time.

Ask your colleagues

Which of your fellow physicians uses medical dictation? Do any of them dictate clinical notes during patient visits? 

Dr. Mark Casillas is an orthopedic surgeon in San Antonio who dictates using Mobius Conveyor , a premium medical dictation software that works on Mac and PC. Here’s how he describes his logic for dictating notes during patient visits : 

“I like dictating the history, physical exam, and my plan in front of the patient because I can pause and ask them, ‘Is there anything I should have added or emphasized?’ They like to hear that I can dictate everything, and for me, it’s a matter of convenience that it’s all documented in the moment.” Dr. Mark Casillas, MD

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How to Use Notes in a Speech: A Guide for Speakers

Only one of the following statements is true. Do you know which one?

• You should never use notes because you will look unprepared.
• You should always use notes because memorization weakens your delivery.
• You should never use slide text as notes.

In this article, we identify scenarios where a full script is warranted or where memorization is advisable. For all your speaking scenarios in the middle, we discuss 21 tips for using notes effectively .

Full Script, Notes, or Nothing at all?

A previous Six Minutes article ( how to read a speech ) identified several speaking scenarios where reading a full script may be required or preferred :

You are speaking at a highly  formal occasion  (e.g. a commencement speech) You are delivering a particularly  emotional speech  (e.g. a wedding speech, a eulogy) You are forced to read word-for-word by  lawyers or campaign managers  (e.g. a corporate statement; a political speech) A  speechwriter  has written your speech. Life  prevented you from preparing  adequately. (Don’t let this happen often… your speech really would go better if you prepare.) You are a brand new speaker, and  you haven’t developed the confidence  yet to go without a script.

Likewise, there are speaking scenarios where it is highly desirable to avoid any notes  and memorize your speech instead:

• You are giving a TED talk  (or speaking at a similar “ballroom” event) where you’ve got twenty minutes or less. These events set a high bar for preparation.
• You are pitching to investors, potential customers, potential employers, or any type of career-shaping presentation . I would include many academic and industry conferences in this group, although some may have a less rigorous culture.
• You are offering a short toast .
• You are completing a course speech assignment, and you are not allowed to have notes.
• Your speech is so short (~ six minutes or less) that you ought to be able to deliver without notes.

If we eliminate those two extremes (full script and no notes at all), we are left with a majority of speaking scenarios where using notes is perfectly acceptable . These include:

• You are teaching a course, which is several hours or days in length.
• You are delivering a keynote address or some other lengthy speech at a conference.
• You are delivering a lunch-time seminar.
• You are addressing a service club or community group.
• You are delivering a webinar.
• You are doing a routine presentation at your workplace.
• Any other scenario where your speech is too long to memorize, but not formal enough to demand a full script .

If you are ever concerned about the culture and expectations for an event at which you are speaking, consult with the organizers. If this isn’t possible, err on the side of caution and be prepared to present either without notes or with absolute minimal notes.

Tips for Using Notes Effectively

If you decide to use notes for your presentation, you still have several choices to make. What medium do you choose? Can you use slide bullets for notes? Does it matter how your notes are formatted? What messages can you pass yourself within the notes? How do you deliver with notes in a way that doesn’t hamper your impact?

Choose the medium that suits your style.

“ The purpose of notes is to jog your memory, not provide lengthy passages to read. ”

• Use a classic: index cards. Many speakers–from elementary school students to career professionals–swear by index cards. If this is what you like, invest in a good hole punch and link all the cards together with a metal ring. This prevents the disastrous “Oh my! My cards are out-of-order” phenomenon.
• Go big (or at least letter-sized). Some people prefer using legal pads or standard letter-sized paper. The main advantage is that you can fit more on a page, so you won’t need to flip pages very often. For many presentations, a single one-sided page is all you’ll need.  [This is my personal preference.]
• Go little: sticky notes. I’ve seen a couple professional trainers work from a large cardboard “palette” covered with many little colored sticky notes, each with a word or phrase. As each topic was covered, the trainer adeptly moved the corresponding note to the “done” pile to keep track of what they had covered. This allows a highly adaptive presentation style where you can cover content in an audience-driven order or not-at-all.
• Go digital with a tablet. There are countless note-taking or outline apps that can do the job for you. Some people love that it’s paper-less; others worry about the device staying charged long enough to be useful. Having to “swipe” your device back on from a black screen every time you need to consult your notes could be annoying, for you and your audience.
• Use presentation software… but do it properly. If you are presenting visuals, then the notes feature of your presentation software (e.g. PowerPoint) can be used in two distinct ways. In the first method, you can print out a set of “notes pages” which combine the slide content with your notes content. In the second method, you can use “Presenter View” to display your slides for the audience and, simultaneously, your slides and notes for you. For a well-rehearsed speaker, this can work very well. (Don’t show up at the event expecting to learn it on the fly!) Finally, do not ever use text on slides themselves as your notes. Audiences universally hate this.

Design your notes for easy consumption.

“ Do not ever use text on slides themselves as your notes. Audiences universally hate this. ”

• Minimize the words. Remember that the purpose of notes is to jog your memory, not provide lengthy passages to read. Don’t use sentences; use keywords or phrases instead. For example, you might distill an entire talk into short notes like “crutch metaphor”, “dentist story”, or “personnel strategy”. Verbose notes leads to two equally bad outcomes: [1] lots of reading, and [2] a high likelihood that you’ll get lost in your notes.
• Maximize scan-ability. Regardless of which medium you choose, be sure to type or print as neatly as possible. The last thing you need to do during your presentation is to decipher a messy or handwritten notes page. Use the largest font you can, and plenty of white space.
• Format wisely to provide clues. Used strategically, formatting such as bold, italics, underline, and color or size variations allows you to convey meaning to your future self.
• Adjust with colored pens or highlighters. Let’s say you’ve got a nicely printed notes page, but while rehearsing you realize that it’s missing a few words or some emphasis. A little touch-up with a colored pen or highlighter will fix it. Avoid using light pencils as it can be hard to read and it is prone to smudge.
• Use meaningful layout. Mirror your speech outline in the notes. Assuming you’ve distilled each point (paragraph), anecdote, or story down to a few words, these can still be displayed in a hierarchy that mirrors your speech outline.
• Organize in whatever style works for you. Don’t be afraid to use any organization scheme that works for you. One of my speaking mentors sometimes uses a single-page mind map as her “notes” page. I don’t think this method would work for me, but it worked wonderfully for her. Experiment!

Use notes for strategic purposes.

• Use notes for other people’s words. You can memorize quotations or a short excerpt of another work (e.g. a poem, story, or news article). However, there’s virtually no down side to reading it from your notes instead. An added bonus is that it signifies the respect you have for the other author.
• Aim for precision. Similarly, facts, statistics, and definitions can be memorized (and definitely should be if they are used in your speech opening), but it’s often safer to just put them in your notes. Reading a statistic from a note (as opposed to memorizing it) signals that you value truth and precision over appearing polished and “smart”.
• Remind yourself to interact with audience. In the past, I was prone to forgetting things like polling the audience, or doing a brainstorm exercise on a flip chart. (I think these items are easy to forget because they are always skipped during rehearsal.) So, I developed a habit of inserting clues like “[POLL AUDIENCE!!!]” or “[FLIP CHART]” in my notes to remind me.
• Remind yourself about timing or logistics. When I teach courses that last several hours, my lesson plan includes a rough timing breakdown which tells me that I should complete the first section in twenty minutes, or complete the group exercise by the ninety minute mark, and so on. I insert these timing reminders right into my notes, and I do the same for other logistical reminders such as “[STRETCH BREAK]” or “[DISTRIBUTE 2nd HANDOUT]”.
• Spell unfamiliar words phonetically to aid pronunciation. In a 1963 speech from Berlin, U.S. President John F. Kennedy uttered the famous phrase “ Ich bin ein Berliner ” (I am a Berliner). President Kennedy desired to pronounce this phrase correctly, so he wrote the words out phonetically: “ Ish bin ein Bearleener ” (his handwriting is shown in the photograph below). Though I don’t recommend handwriting today, I’ve often used this trick as a Master of Ceremonies to avoid pronunciation mistakes when introducing other speakers.

Handwriting of President John F. Kennedy to indicate the correct pronunciation of several speech phrases.

Deliver with confidence.

• Don’t apologize for having notes. It’s okay to have notes. Really! I cringe whenever a speaker apologizes for “needing” notes… not because the apology is so tragic, but rather because it usually signifies a lack of confidence. Prepare and deliver to the best of your ability, and skip the apologies.
• Practice with your notes, and revise as necessary. Just as with visuals, props, or anything else you intend on having with you during your presentation, rehearse with your notes. As you practice, add keywords to your notes if there’s a point, a story, a transition, or anything else you tend to forget. If you’ve never used “Presenter Mode” with slides before, then practice!! I’ve seen dozens of people launch into this mode without any prior preparation, and it usually kills a few minutes pointlessly.
• Glance at your notes at natural breaks. When you are speaking, try to keep your eyes up on your audience. Take advantage of natural pauses to refer briefly to your notes. For example, when I teach courses, I tend to glance down  just after  I change the slide. At that moment, the audience will direct their attention to the new slide, so this is a perfect opportunity. Once you’ve finished, bring your head back up and begin speaking again.
• Avoid glancing at your notes at critical moments. Your opening, closing, and any other “core moment” should be delivered with confidence, and glancing at your notes at this time will detract.
• Put your notes down… if there’s a place to put them. If you carry your notes around, it can be a visual or auditory distraction. Also, if you’ve got anything in your hands for a long period of time, it tends to limit natural gestures. If there’s a lectern, table, or any convenient surface, that will work. But if there is literally no where to put the notes, then just hold your notes in your hand. (Don’t put them on the floor. Bending down repeatedly will lead to awkward moments that are best avoided.)

Put in into Practice

Think about the next presentation you are scheduled to deliver.

• Are notes appropriate for this setting?
• How can you improve the content of your notes?
• Do you have quotations, facts, or other content that can go into notes to lessen your cognitive burden?
• Is today the day you will learn how to use Presenter Mode in your presentation software?

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Was talking to a client this afternoon about using notes when #presenting. Here is another great article from… https://t.co/M6Coa1JM6i — Mel Sherwood – Pitch & Presentation Specialist (@MelSherwood_) Dec 7th, 2018

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A Noteworthy Idea

Mannerofspeaking.

• August 5, 2009

When delivering a speech or presentation, it is preferable for a speaker to do so without notes whenever possible.  Being free from notes allows a speaker to have maximum eye contact with the audience . The speaker can also move out from behind the lectern and use the full speaking area. And, it conveys to the audience that the speaker is comfortable with the subject.

However, depending on the length of the presentation, its complexity and the amount of time available to prepare, speaking without notes is not always possible.  In those cases where you have to use notes, here are some ideas for using them effectively:

Keep notes to a minimum

Having your speech written word for word will tie you to it.  You will be reading out loud and not speaking .  If you look up from the notes for even a brief period of time, it could be difficult to find your place when you go back to them.

Points, not paragraphs

Do not write your notes in paragraph form.  Y ou will get lost.  Better to write them out in point form with only one or two lines per point.

Many people have their notes written in size 12 or even 10 font, the same that they use for printed documents.  Unless you have extremely good eyesight, small fonts will be difficult to read without squinting at your notes or picking them up or bending over the lectern to get a closer look.  Your notes are for you . So increase the font to 18 or 20 so that y ou can easily read your notes .

Organization

Having a mess of papers makes it too easy to get lost.  If you have notes on standard letter-size paper, put them in a binder.  Make sure beforehand that you can turn the pages easily.  If necessary, add tabs or “dog ear” the corners of the pages.

Many people suggest using speaking cards with key points.  The advantage of such cards is that they will allow you to move about on the stage.  The disadvantage is that they limit your ability to gesture with the hand holding the cards and they can be distracting to some in the audience.  And you do not want to drop them!  Practising your speech with the note cards beforehand will help things go more smoothly.

If you have a PowerPoint presentation, you can use the slides to keep on track.  One thing to avoid, is reading the slides with your back to the audience.  When going to a new slide, you should pause, turn to the slide and quickly collect your thoughts, turn back to your audience and then speak.

If you do use a lectern , it would be great if you can get out from behind it from time to time during your speech, provided that the venue is suitable for doing so.  A good example of when to do is when recounting a personal story that helps drive home your message.  You should not need notes as you have lived the story.

Step out from behind the lectern, even if it is only a short distance, and tell the story.  Then, as you are approaching its conclusion, return to the lectern, check your notes and move on to the next point.

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John delivered a keynote address about the importance of public speaking to 80 senior members of Gore’s Medical Device Europe team at an important sales event. He was informative, engaging and inspirational. Everyone was motivated to improve their public speaking skills. Following his keynote, John has led public speaking workshops for Gore in Barcelona and Munich. He is an outstanding speaker who thinks carefully about the needs of his audience well before he steps on stage.

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TA Leader, Gore and Associates

I first got in touch with John while preparing to speak at TED Global about my work on ProtonMail. John helped me to sharpen the presentation and get on point faster, making the talk more focused and impactful. My speech was very well received, has since reached almost 1.8 million people and was successful in explaining a complex subject (email encryption) to a general audience.

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John gave the opening keynote on the second day of our unit’s recent offsite in Geneva, addressing an audience of 100+ attendees with a wealth of tips and techniques to deliver powerful, memorable presentations. I applied some of these techniques the very next week in an internal presentation, and I’ve been asked to give that presentation again to senior management, which has NEVER happened before. John is one of the greatest speakers I know and I can recommend his services without reservation.

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I was expecting a few speaking tips and tricks and a few fun exercises, but you went above and beyond – and sideways. You taught me to stand tall. You taught me to anchor myself. You taught me to breathe. You taught me to open up. You taught me to look people in the eye. You taught me to tell the truth. You taught me to walk a mile in someone else’s shoes. I got more than I bargained for in the best possible way.

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World Cancer Day Campaign Manager, Union for International Cancer Control

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Writing in the Notes – an overview

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The ability to write in a patient’s notes effectively is an essential skill all medical students need to learn. Accurate documentation is also incredibly important from a medicolegal perspective. This guide provides an overview of how to write in a patient’s notes and should hopefully make you feel a little more prepared when you have your first attempt on the ward.

Ok, so a blank continuation sheet has been thrust towards you and you’ve been asked to document something – let’s remind ourselves of the basics of documentation.

What should I use to write with?

You need to use a pen with  black   ink , as this is the most legible if notes are photocopied.

Patient details

For every new sheet of paper your first task should be to document at least  three   key   identifiers  for the relevant patient:

• Date of birth
• Unique patient identifier
• Home address

If a  patient   label  containing at least three identifiers is available, then this can be used instead of writing out the information manually.

Location details

You should indicate the patient’s current location on the continuation sheet:

Making a new entry in the notes

At this point, you should already be holding a pen with black ink and you should have ensured the continuation sheet has at least three key patient identifiers at the top.

How to make an entry in a patient’s notes

1. Add the date and time (in 24-hour format) of your entry.

2. Write your name and role as an underlined heading.

3. Make your entry in the notes below this heading (see our other documentation guides ).

4. At the end of your entry to need to include the following:

• Your full name
• Your grade/role (e.g. Medical Student/F2/Neurology Registrar)
• Your signature
• Your professional registration number (e.g. GMC number)
• Your contact number (e.g. phone/bleep)

Other things to be aware of…

What if your entry spans more than one page.

If your entry in the notes happens to span more than one page :

1. Write “continued on the next page” or “continued” with an arrow pointing off the page after the entry on the first page.

2. Write your name, signature, professional registration number and contact number at the end of the first page.

3. Add the patient’s name, date of birth and unique identifier to the new page.

4. Write the date and time of the entry on the second page.

5. Write your name and role, followed by the word “continued” as an underlined heading.

6. Continue the entry from the previous page.

7. At the end of this entry, you need to include all of your details:

Although this may seem tedious it’s actually really important, as it ensures the chronology of your entry is clear to others reading it later.

What if you are too busy dealing with sick patients to write in the notes at the time?

You should always try to document your patient encounters as soon as possible to both reduce the risk of forgetting key details and to ensure other team members are aware of any changes to a patient’s condition or management plan. However, in reality, this isn’t always possible, for instance, if you’re dealing with an acutely unwell patient you need to prioritise their management over the documentation of the sequence of events.

When you return to the patient’s notes at a later time you need to:

1. Ensure the continuation sheet has the patient’s three key identifiers as previously described.

2. Document the current time and date of your entry.

3. Write your name and grade as an underlined title.

4. Begin the entry by stating that this is written in retrospect, with the time the entry is referring to documented clearly.

5. Complete the entry in the notes.

6. At the end of this entry, you need to include all of your details:

What if I write something incorrectly in the notes?

If you make a mistake whilst making your entry (e.g. factual error/spelling error):

• Simply cross the mistake out with a single line through the erroneous words.
• Write your signature in addition to the time and date beside the area crossed out.
• Do not use Tipp-Ex to erase the errors.
• Do not excessively scribble over the errors to make them unreadable.

Filing the documentation appropriately

You should ensure that you file your documentation in the appropriate place within a patient’s notes. This can differ significantly between hospitals, so ask the team if you’re unsure.

Make sure to put the patient’s notes back in the appropriate trolley or storage area on the ward once you’re finished.

Hopefully, that was a useful overview of the basics of documentation. Check out our collection of documentation guides to further refine your skills.

• Royal College of Physicians. Generic medical record-keeping standards. Available at: [ LINK ].

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