HPI Reflection

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

Since I felt more comfortable in the Spring semester, it was easier to elicit pertinent positives and negatives before going through the ROS and to make connections. However, my initial DDx was very narrow and I have to admit patient’s actual problem was not on it during the interview.

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

I learned to ask why certain things were happening instead of just documenting facts as it is a good way to elicit additional information . It is still work in progress as I believe a good history taking includes having a broad list off Differential Diagnoses in the back of my mind and ruling them in/out as I go which is a skill on it’s own.

3. In what ways has writing an HPI improved?

After Clinical Correlation exercises things don’t appear as daunting anymore as they used to. I am getting somewhat of a sense of organizing information and ability to keep it in my head. Taking history with a group is challenging but also is a very useful exercise: when some members jump ahead, it gives me a chance to locate and fill the gap they have missed which solidifies the order of things in my head.  

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

We haven’t finished the Physical Exam course yet so it’s hard to tell. I enjoy heart and lung exam as I feel like it puts patients at ease and they usually let me listen for as long as I need to.

I still feel weak at doing a complete exam as it seems to take forever – I definitely need to work on becoming time efficient.

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? 

Time management while interviewing/examining: sometimes I take my time wanting to be thorough and end up tiring the patient because it takes forever, then other times I try to speed things up & end up missing important information and opportunity to counsel which haunts me for weeks to come.

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