Prompt: “Please post a reflection on what you have learned in the two semesters. Please comment on skills you now have that you did not have at the beginning of the 2-semester series and ways in which you now understand more about evaluating patient findings and evidence as well as formulating a differential diagnosis and treatment plan. Please also note areas that you plan to work on more during the clinical year. Be as specific as you can – this will help you in focusing on key elements in the coming year”
During my previous job as a medical scribe at CityMD, I learned how to do a focused interview. In 95% of patient visits, I was the first one to establish patient contact, obtain the chief complaint, write the HPI, discuss PMH, verify medications/allergies, and conduct a review of systems. This experience was amazing, but it did little to prepare me for what I would need to do to address the patient’s concern. As I studied throughout didactic year, I was always worried about starting our clinical correlations class. At the time it seemed to be the toughest learning experience we would take on, it was. At this moment, I would say that it was also the most enriching learning experience that we have had.
Our clinical correlations class gave me an opportunity to develop skills in evaluating a mock patient, formulating differential diagnoses, and ascertaining a treatment plan. I found it encouraging to work through the presented scenarios as a small group and noticed that our deliberations were very constructive and informative. We emulated a medical team and bounced ideas off each other and off our instructor. I became familiar with navigating and utilizing UpToDate and AccessMedicine. With these tools I became more confident as we tackled tougher cases within a wide variety of simulated clinical settings. I also became a confident and focused presenter; this is mostly due to the number of medical articles we would have to read to prepare for our presentation. In addition, this mode of learning helped me understand many medical concepts, it seems that sometimes the best way to learn is to try to teach someone else. Lastly, I found it particularly helpful that we practiced explaining our findings and diagnosis to the patient/family member. I quickly realized that it was one thing to be able to explain a concept to my peers but an entirely different ordeal to explain it to someone without a medical background.
Within my upcoming clinical year, I have a lot to focus on. Particularly, I learned an important lesson on how harmful tunnel vision can be, especially when a patient’s life is in imminent peril. I recall that in one case we were so fixated in discussing imaging and interpreting a patient’s EKG, that none of us considered ordering a serum lactate level and indeed our patient was septic. Another thing that was constantly reiterated was to treat the patient not the lab values. The patient’s presentation and vital signs should always be in consideration when formulating a treatment plan. Lastly, I want to focus on improving and perfecting my physical exam skills. I would like to be able to properly interpret physical exam findings, especially heart sounds. In all, I want to continue honing the skills that I have developed throughout the didactic phase and build upon them.
