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

One major difference that I saw between my H&Ps was the format of my chief complaint. In my first HPI, I added a lot of information into my chief complaint which was  irrelevant/ or in the wrong area of my HPI. My final HPI had a clear chief complaint which included all the necessary information without adding irrelevant material like what drugs the pt is currently taking. I also learned through the two that my pertinent negatives should be right at the end rather than throughout my chief complaint. As time went on I was also able to perform more physical exams throughout my HPI. 

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

A great way my history taking has improved is that it is much more focused on the problem at hand. In my first visits, I would ask questions that were not directly related or necessarily needed to be asked. I also missed some questions from my history-taking as it took me a long time to ask and lack of confidence.Now I am able to make questions that are more specific, which allows the pt to share more information as they have a better understanding of what  I am trying to ask.This helps me get the most important information needed in a short amount of time.

3. In what ways has writing an HPI improved? 

As time went on, my HPI improved as I learned more throughout the semester. There were times while I would ask certain questions, I started to build a DDx. This helped me ask questions that needed to be included in my HPI. This helped me develop a flow in which I would write my HPI as I interviewed the patients. 

4. What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?

As the semester went on, I felt more confident in performing my physical exam. But I do tend to forget certain procedures and it is something I can definitely improve on. When performing my auscultation, I had forgotten the ladder-like problem. So I definitely need to review some physical exam maneuvers and understand the significance in why I have to do them in a certain way. My strongest feature would be my timing. I feel that I get most of my exams done in a timely manner, making sure the patient does not have to wait extended periods of time as I do an entire physical exam on them.

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? 

One area I would definitely need to improve would be my physical exam as I stated above. I sometimes am not able to perform the exam correctly which may obscure my results. As I go into my clinical year it is vital that I’m able to perform a thorough physical exam so I can help as many as patients as I can