1. What differences do you note between the two H&Ps?
One major difference I note between my H&Ps is the difference in my HPI format. One HPI is a little more confusing to follow because it encompasses multiple complaints and I think it could have been structured better. The other HPI is easier to follow and more of a story, which is better for the reader. I think I followed a similar structure/format for both H&Ps overall, the difference is the physical exams performed and HPI structure.
2. In what ways has your history-taking improved? Are you eliciting all the important information?
My history-taking has improved because it has grown to be more focused. Towards the beginning, I would say it was broader and I wasn’t always asking the right questions to elicit the right answers I was looking for. I noticed that from my 1st session to my 3rd session the visit was faster, likely because I knew and had developed my own flow and what questions/ways to word my questions better. I think I am eliciting all the important information because I ask questions that are broad enough to allow the patient to share as much information as they can and then ask more focused questions to fill in the gaps.
3. In what ways has writing an HPI improved?
My HPI writing has improved because I have developed a technique to follow. Also, learning about more disease processes as the semester continued allowed me to ask questions for my HPI that were more tailored to whatever system the complaint was about or what diagnoses were on my differential when hearing the patient’s story. Also, I learned to omit certain things from my HPI that aren’t necessary and can be included in other parts of the H&P.
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 feel as though I am proficient in performing a physical exam. Since I am still learning, there is always room for improvement. One thing I feel is a weak part of mine is my timing. The physical exam part takes up a good chunk of time for me and I think with more practice I can improve my speed. One thing I feel strong about is making the patient feel comfortable, I think this involves with the way that I speak to the patient and asking permission/explaining what I am going to do before I do it.
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 would like to specifically target moving forward is my physical exam. I think as we learn more parts of the physical exam next semester it can become more difficult to be efficient since there are many systems. I will practice more so that I can become more efficient and focus on the smaller things that are easily forgettable.
