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

My most recent H&P is more focused and provides more clarity into the reason that the patient is visiting. In contrast my first H&P has a very wordy HPI and missed crucial information regarding the patient’s PMH.

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

I have significantly improved in taking PMH. I ensured that all prescription medications were inquired about in full detail. If there was any information that I forgot to ask I did not hesitate to jump back and inquire more about PMH, surgical, and FMH.

In what ways has writing an HPI improved?

My writing has become more centered on delivering pertinent and concerning patient information. My first HPI included everything that the patient had mentioned instead of homing in on the main concern that brought her to the ER. My last HPI was succinct and appropriate to the patient’s main concern.

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 confident in my ability to conduct a general, HEENT, skin, hair, nails, neck, and abdominal exam. I have practiced sets of these exams with my peers and I feel comfortable using my examination tools. I feel weakest in my ability to conduct an   accurate and through heart, lungs, and neuro exam. These segments of the physical will hopefully improve with experience but at this time I have trouble discerning the various heart and lung sounds.

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? 

I need to further improve my capabilities in taking a comprehensive and focused HPI. This is partly due to my personal inexperience in dealing with the totality of issues that a patient may present with. Our clinical correlations class was highly effective in mitigating improving my experience level. My hope is to improve upon what I learned and practice with actual patients in the upcoming clinical year.