- What differences do you note between the two H&Ps?
I noticed that my very first HPI lacked many details compared to my last HPI from the hospital visits. In the first HPI, there were some fields that I didn’t complete and some that when I did complete them, I did not provide specifics for example the family hx I did not note when family members were diagnosed, cause of death, or if they were alive and their age. However, by my HPI 3, I was better at filling out these specifics and providing more information.
2. In what ways has your history-taking improved? Are you eliciting all the important information?
Yes, I have noted an improvement in my history eliciting skills. On the first day of my hospital visit, I was a bit anxious and didn’t ask as many questions as I should have but by the third HPI, I was able to ask more questions and follow up on points that patients would make on the side. I would be able to get information from the patient about medication in passing and would ask them about the medication or health issues associated with the medication which they may have failed to mention. I also felt that the feedback the preceptors gave encouraged me to think more critically and try to dig out information that would be helpful to understanding each case especially since we had to present them to our preceptors.
3. In what ways has writing an HPI improved? (hint: look at the rubric scores)
I have improved in my analysis of the patient’s HPI, my communication with the patients, and my ability to elicit important information. My logic and flow in my HPI writing have also improved much.
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 comfortable in my skills in most of the areas of the physical exam components that we have learned so far. Although our in-person practice was somewhat limited I was still able to practice the skills over the semester with my classmates and friends. I however do not feel as comfortable with my eye exam (fundoscopy particularly) and cardiovascular assessment for murmurs, but I will keep practicing because I realize how important a good and accurate physical exam is to patient care.
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?
I mentioned this in the last prompt, but I do want to focus more on fundoscopy and being able to do it proficiently. I also will focus on cardiovascular. I want to sharpen my skills in being able to decipher what different murmurs sound like and being able to pick up on them and do so confidently.
