H&P Reflection
- What differences do you note between the two H&Ps?
From physical diagnose I, I chose my last H&P which was on a patient from internal medicine. From physical diagnose II, I chose my second H&P which was on a patient from preadmission testing. Between the two H&Ps, there is not much differences in the ROS section. Although, on the preadmission testing H&P, I was able to perform more physical exams despite having shorter amount of time. In the internal medicine H&P, the past medical history, family and social history were more completed than preadmission testing H&P.
- In what ways has your history-taking improved? Are you eliciting all the important information?
I consider that now I am slightly more competent when asking questions pertinent to the patient’ symptom and disease. At the beginning, I used to focus only on asking questions about the system of interest ignoring other systems that could be affected. Taking pathophysiology and clinical medicine were very helpful to integrate that skill.
- In what ways has writing an HPI improved? (hint: look at the rubric scores)
I still need to improve when writing an HPI, specially meeting all components of OLDCARTS. I do feel I have improved on pertinent negative and positives. Although, I need to write my HPI in more direct and concise manner keeping sentences simple.
- What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?
I certainly have to improve on performing physicalexams. My weakest areas are blood pressure, fundoscopy and cardiac exams. I feel my skills to identify abnormal heart sounds and retinopathy are not well-developed yet. In term of blood pressure, sometimes I feel insecure with my blood pressure readings. Although, I am conscious that I need to keep practicing to improve in these areas. In terms of my strongest areas, I feel very confidence when doing the ear, nose, mouth and abdomen exams.
- 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?
Moving forward into the clinical year, I have to be faster and more efficient when performing physicals, specially the cardiac and lungs exams. Another area of focus will be developing differential diagnosis which is essential skill in clinical years.
