- What differences do you note between the two H&Ps?
I noticed that I became better at keeping my HPIs more concise, but still making sure I have all the information. There is a better flow as well that directs the reader to a certain differential as they read on. My PE finding also became better as I wrote more HPIs.
2. In what ways has your history-taking improved? Are you eliciting all the important information?
In my history-taking, I made sure to ask more details about their conditions. Because I have a better understanding of the disease now, I can ask better follow up questions. For example, if patients tell me they have diabetes, I can ask if it is type one or two. This helps me guide them so I learn more.
3. In what ways has writing an HPI improved?
I am much more concise and make sure to include only important information. I also improved on how well I describe their main complaint instead of just moving on to a different topic. If they tell me SOB I ask about how many stairs they can climb or how many blocks before running out of breath. In my first HPI I would briefly describe the complaint. I also became better at including pertinent negatives.
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 the strongest about my abdomen PE and the weakest in my neuro PE and lung sounds. In a lot of hospital visits, abdominal pain is a common complaint so I had a lot of practice with that. I barely see pts with neuro complaints. When it comes to lungs, I have a hard time differentiating a wheeze from another sound. But, I can tell if it is normal or not.
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 would like more practice with getting a HPI about complaints where we can not use OLDCARTS such as SOB. I would also like to hear more lung sounds so I can become better at those.
