- What differences do you note between the two H&Ps?
I noticed that my first H&P has a lot of missing information. The first HPI was well written, but there are some areas where I could’ve made it more concise. In my third H&P, you can see that I was better about asking the patient more questions under past medical history, but my HPI was not as great as my first HPI because I was not clear as to what issue the patient was there for since he was reporting multiple complaints.
- In what ways has your history-taking improved? Are you eliciting all the important information?
My history-taking has improved regarding obtaining all the information for the past medical, social, and family history, as well as review of systems. In the first H&P you can see that there was a lot of questions I was unable or didn’t get a chance to ask, but in the third H&P you are able to note that I elicited all the important information.
- In what ways has writing an HPI improved? (hint: look at the rubric scores)
While my first HPI was well written overall, I had trouble with what to ask for pertinent positives and negatives. One of the ways my HPI has improved is through noting more of the pertinent positives and negative which helped me think about differential diagnoses.
- What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?
I believe that I am confident about performing a physical exam. One area that I feel I should work on, however, is to perform the physical exam in a systematic approach so that I avoid the risk of possibly overlooking something. The area I feel the strongest about regarding performing a physical exam is remembering all the components of the physical exam.
- 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 area I really want to focus on is asking the pertinent questions while formulating my HPI. I really had a lot of trouble with knowing what to ask for pertinent positives and negatives, and I feel like that is a crucial part of the patient interview as it can help guide you towards differential diagnoses.
