H&P Reflection

First HPI:

Last HPI

Reflection:

  1. What differences do you note between the two H&Ps? In my first HPI I was not specific and did not include all of the pertinent pre-existing information in the first line of my HPI. In my last HPI, I was able to include concise and relevant information in the HPI. In my last HPI, I can read my confidence and see the flow within my HPI.
  2. In what ways has your history-taking improved? Are you eliciting all the important information? I still remember my first H&P where I was so nervous and unable to get all the information I needed on the patient. I was also, not taking the history in an orderly manner or eliciting all the important information. For example, I would forget about the pertinent positives and the pertinent negatives. To improve my history taking before I entered my patient’s room I took deep breaths and ensured that I went through OLD CARTS in an orderly manner.
  3. In what ways has writing an HPI improved? (hint: look at the rubric scores) My HPI writing has improved in placing the important pre-existing conditions within the first line, including all OLD CARTs criteria and placing relevant information to promote  the HPI.
  4. What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about? Currently I do believe that I know how to perform a proper physical exam. I am more comfortable performing lung, abdominal and heart exams than Eyes and nose exam. The eye exam is my weakest point due to all of the nuances and mini exams in there.
  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? Doing H&P write ups in PD 1 has taught me that the H&P slightly changes based on where the patient is. For example , if a patient is inpatient a brief hospital course will be added after the presenting symptoms OLD CARTS while in the Emergency department , OLD CARTS is taken to find a diagnosis.  For my future patient visit, I need and will focus on going through the whole OLD CARTS criteria and being more specific in obtaining the patient’s medical and surgical history.