The clinical case presentation as a narrative: Form and practice

Abstract

This paper examines an underrepresented genre of spoken clinical discourse – the clinical case presentation. Since little generic research into this peer-to-peer speech event has been conducted and also due to the fact that case presentations are often neglected by English for Medical Purposes (EMP) teachers, particularly those without backgrounds or experience in medicine, the author will explain both how and why case presentations are constructed and performed, particularly by clinicians who practice in non-English clinical milieus. This study is based upon a number of observations carried out at 10 clinical university hospitals in non-English normative parts of Asia, involving observations of a total of 36 distinct clinical case presentations performed in 10 different clinical departments. These observations were further supplemented by structured interviews with senior clinicians, instructors, training program designers, and presenters. One of the prominent features noted of expert presenters is that their presentations tend to extend well beyond the mere conveyance of clinical data and serve to express a narrative – the story of the patient’s case – which produces a more holistic impact upon the audience. Features of narrative that are incorporated into this speech event will be discussed, followed by a discussion as to how the teaching and learning of case presentations might best be carried out in EMP classes.