1. What differences do you note between the two H&Ps?

One major difference I note between my H&Ps is the assessment and plan section. In my final H&P I had a more specific plan for my patient and what should be done moving forward with the patient’s treatment plan. My assessment was also more specific. I think I also had a more detailed HPI in my third H&P.

2. In what ways has your history-taking improved?  Are you eliciting all the important information?

My history-taking has improved because I am able to start broad and then get more focused to help specifically narrow my differential. I was more specific and included more pertinent negatives and positives in an attempt to help paint a better picture of what is going on with the patient. I also attempted to make it flow more so that it could be more logical and understandable dealing with the progression of symptoms. I think I for the most part elicited the important information, however I do think there are still some things I could specify to make things a bit clearer.

3. In what ways has writing an HPI improved? 

My HPI writing has improved because the practice over the semesters has allowed me to see how an HPI should be written and what should or should not be included. I also am able to tailor my history taking to what I think is important to have in the HPI. I have learned what should be in an HPI vs. what can go in other areas such as patient history or ROS.

4. What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?

I am definitely a lot more comfortable performing a physical exam now than I was at the beginning of the semester. I think our last PD exam of a head to toe physical really helped me to tie everything together and know what things are important to always check for and what things may not be needed in an otherwise healthy patient. I also was able to see an improvement in my timing as I progressed.

5. Of course we expect you to get stronger in all areas, but which of the specific areas will you target as needing particular focus in future patient visits when you start the clinical year? 

One thing I am trying to focus on in the beginning of clinical year is developing and carrying out my plan. I want to work more on patient counseling and how to speak to patients to help them understand in their terms what is going on and how it can be improved. I would like to develop my plan pertaining to what should be done and when, especially when dealing with emergency situations and what the order of things should be.