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

The two H&Ps are very similar in structure. In the 3rd H&P, my vitals are placed in the correct area.

In terms of patient differences, the pt in the 3rd H&P had an extensive medication list while the 1st pt has none. Also, there is a difference duration of the chief complaint. Since the 1st patient was in acute distress, not all questions in the H&P could be asked. However, with the 3rd patient, it was more relaxed which allowed the pt  to expand on more details. The 3rd pt had an extensive PMH while the first only had 1 known diagnosis.

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

My history taking has improved by knowing what speed to ask questions based on severity of the situation. Yes, I have elicited all of the important information and focused on it for the majority of the 1st patient who was in acute distress

In what ways has writing an HPI improved? (hint: look at the rubric scores)

My HPI writing has improved by using a systematic approach. After reading comments from Professor Malavet on my first H&P, it was clear that I needed to continue this approach while writing an HPI. I learned that if a pt had 10/10 pain, that should be mentioned as soon as possible, in the “present illness” portion.

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

I believe that I am well capable of performing appropriate and indicated physical exams. This is what i enjoyed most during the course because it connected information from the 1st and 2nd semesters of PA school. I feel strongest with doing the cardiac exam and weakest doing the abdominal exam because it is extensive.

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 will focus on performing physical examinations. I feel that the more I practice parts of the physical exam, the more I remember it. This also means the more time that I’m not doing physical exams I may forget certain techniques. I hope to examine as many patients as possible to know what it “normal”, so that when I see something that is not normal, I can recognize it.