Developing an Abstract

Clinical vignettes, or case reports, are patient-related cases and scenarios that have educational value for a wider audience. Good cases come in many different flavors. Some describe unusual diseases, whereas others are unusual presentations of a common disease. Any case that illustrates a key point or points about diagnosis, management, or therapeutic decision making can make a good clinical vignette.

Once you've identified a possible clinical vignette, you'll want to enlist a mentor to guide you through the process of preparing an abstract. This is generally a project that the attending who first cared for the patient will agree to do. If they decline, you can ask any other member of the faculty. General Internal Medicine and Population Science faculty are happy to help.

The first step in presenting or publishing your clinical vignette is to prepare an abstract according to the following outline:

• Title. Clinical vignette titles are often descriptive of the case being presented, or they employ humor to cleverly pique a reader's interest. Try not to give away the diagnosis in the title.
• Learning Objectives. Write two to three learning objectives for your clinical vignette A learning objective states what someone will as a result of reading your vignette presentation. Your learning objective should contain an action word such recognize, diagnose, assess, treat, distinguish or manage. A list of good action words is available here.
• Case Presentation. Briefly summarize your patient’s presentation, workup, diagnosis, and treatment. This should not be comprehensive, but should include the key points of the case presented in a clear, organized and easy to read fashion.
• Discussion. Discuss the main teaching points that your case illustrates. This may include a suggested diagnostic approach to a patient presenting with a specific problem and/or information about the diagnosis, management, or treatment of your patients specific diagnosis. When writing the discussion, think about what you want the reader to learn from your case.

Designing A Poster

If you are planning to present your abstract at a symposium or competition, you may also need to design a poster to accompany the oral presentation. Follow these tips to ensure you have an engaging visual representation of your case. Note: UAB has an on-campus resource for printing these large-format documents.

• Arrangement. Your poster should have a definite sense of direction and flow. It should generally read from left to right. Learning objectives are usually top left followed by a description of the case. Far right is for references and conclusions/take home points. The middle is for pictures, diagrams, tables and other text to discuss your case and its key learning points.
• Avoid too much text. The number one issue with many posters is too much text. Keep text to the minimum and use bullets, graphics, graphs, and pictures instead. See examples below.
• Font. Use a simple sans serif font in a large size. Smallest font should be 18 point and 24-28 point font is commonly used.
• Keep it simple. Present a few main ideas well. Make sure your poster clearly makes these teaching points and avoid overcrowding. The content of the poster should be able to be absorbed in 5 minutes or less.

Delivering an Oral Presentation

When making a presentation of your clinical vignette, it is important to keep the following guidance in mind. These tips have been develped from published articles and compiled by Analia Castiglioni, MD; Amanda Salanitro, MD, MS; Erin Snyder, MD; and Carlos Estrada, MD, MS.

Presentation Content

• Build your talk on 2-5 key concepts, refrain from including everything you know
• Maintain consistency between slides and talk
• Know your audience and gear the talk to their skill level, beliefs, and motivations
• Anticipate questions

Slide Organization (for a 10-minute presentation)

• Introduction and Learning Objectives: 1-2 slides
• Case Description: 2-4 slides
• Discussion: 2-4 slides
• Take Home Points: 1 slide
• Plan to spend about 30 seconds to 1 minute per slide

Slide Content

• The audience will read 100% of the slide; delete any excess words.
• Use pictures or movies if you are able, but make sure they are readable from the back of the room.
• Check spelling, check again, and check a third time.
• Don't apologize for slides that no one can read. If it is too busy, distracting, or unreadable, redo the slide.
• Don't put your slides in your luggage. Always keep them within reach.
• Be prepared for e-mail or equipment failure. Always have copies on a portable storage device and on paper.

Formatting and Fonts

• Use bullets rather than prose.
• Limit the information to 5-7 lines per slide, 7 words per line.
• Keep a consistent background throughout the presentation.
• Resist flying, bouncing, or other text or sound effects.
• Use upper and lowercase letters. All uppercase is difficult to read.
• Avoid italics. Use bold, change font size or color, or underline.
• Use sans serif fonts (Arial, Tahoma, Verdana, Helvetica). Avoid distracting or "cute" fonts.
• Don't use more than 2-3 different fonts per presentation.

Structure for Tables and Graphs

• Retype tables rather than photographing or copying from journal articles.
• 2 column table, use < 5 rows; 3 column table, use < 3 rows
• Bar Graphs: Maximum 8 separate bars, or 3 pairs
• Line Graphs: Make each line a different color
• Pie Charts: Start the largest piece at 12:00, move clockwise.
• Use arrows or other highlights to draw attention to the most important points.

Imagery

• For Radiology: consider showing the entire picture in one slide, then zoom in to the area of importance on the next slide.
• For Pathology: consider showing a normal comparison next to your specimen.
• Highlight the important part of the picture (arrow or box).

Practice and Refine the Presentation

• Rehearse 2-3 times, to yourself, your colleagues, your pet, anyone. Consider audio or video taping yourself.
• Listen to feedback from your peers; use it to improve your presentation.
• Move slowly through graphics. Orient the audience to the symbols, axes and content first, then emphasize the key points. 
• Eliminate distracting vocal mannerisms: umms, errs, ahs.
• Ensure that content can be presented in the alloted time.

At the Event Venue

• Familiarize yourself with the stage and the equipment before you start.
• Pay attention to the audience. They will give you clues if you are moving too quickly, if they are confused, or bored.
• If you answer questions from the audience, repeat or rephrase the question, then answer it briefly
• Use the laser pointer sparingly to point out or emphasize something special. Do not keep it on at all times.

Steps to Journal Publication

• A patient with an interesting condition presents to you.
• Identify a "take-home" message or teaching point from the case. Why is this case important?
• Choose a journal appropriate for publishing the case report.
• Obtain the journal's "guidelines for authors."
• Identify a Mentor to help you with the case
• Perform a literature search of journals, textbooks, and electronic media.
• Compile all source articles in a file.
• Assign a reference number to each source in the order obtained and write this number in the right upper corner of each article's front page.
• Write up the case and discussion in the required format using assigned reference numbers to identify sources of information.
• When the article is finalized, renumber sources in order as they appear in the paper.
• Mail to the journal your manuscript with cover letter providing correspondence address, phone and fax numbers, and e-mail address.
• If the article is not accepted by the journal, obtain reviewers' comments.
• Revise paper using reviewers' comments and the guidelines for authors of another appropriate journal.
• Submit article to the second journal.

*Adapted from Brodell RT: Do more than discuss that unusual case: Write it up. Postgrad Med 2000., 108(2):