Prompts for Reflection on PD Lab H&Ps
- What differences do you note between the two H&Ps?
When comparing my two H&Ps, the first thing I notice is the flow in the HPI section. In the first HPI, I use some unnecessary words and takes me a while to get straight to the point. On the contrary, in the second HPI, I think the flow is better and gets straight to the point but at the same time it provides all the necessary details about the patient. I also believe that my pertinent negative in the second H&P are better focused and relatable to the case while in the first H&P, I feel like I should’ve explored the patient’s symptoms more.
- In what ways has your history-taking improved? Are you eliciting all the important information?
When I was taking my patient’s history for my final H&P, I felt more comfortable and confident in my history-taking abilities than the first H&P. My follow up questions after the patients expressed some of their symptoms were more pertinent and specific. I learned how to better listen and allow for my patients to lead the conversation. My conversation with the patient felt more natural in my last H&P and I noticed that the patient also felt more comfortable and relaxed as he was talking to me.
- In what ways has writing an HPI improved? (hint: look at the rubric scores)
In the beginning, I had trouble with properly structuring my HPI and felt that the information was all other the place. However, the more HPI’s I wrote, the more confident I became. As I mentioned before, my flow got better and the structure of my HPI became more coherent than before. Lastly, in my recent HPI’s I also started to include more medical abbreviations as I became more familiar and comfortable with common medical terminology.
- 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 confident in performing a good physical exam and I think I do a good job in making the patient feel comfortable while I perform a comprehensive physical exam. With that being said, sometime my physical exams can take longer than they should, which can be an issue in a busy clinical setting. Another area that I feel weak is finding an abnormality while performing a physical exam and not knowing what to do next or how to follow up. So far, we’ve mostly practiced physical exams on each other and I haven’t encountered as much abnormalities on a physical exam as I would’ve liked.
- 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?
More specifically, Id like to get better at communicating with patients and sounding confident when taking their history. I think its very important to make your patient feel comfortable and gain their trust, so that way they can open up to you more and give you a better history which can hopefully lead to a better diagnosis and treatment. Id also like to perform a physical exam without hesitation and thinking to much. Being able to perform a thorough physical exam in a timely manner is very important and adds to that patient trust.
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