• What differences between the two H&Ps?

The first difference I noted between the two H&Ps was the difference in detail. The interview for our first HPI was done via a class simulation, and so we as a class, were able to take our time to ask our “patient” for different details such as the dosage for every medication, and the last time they took it was. Additionally, our “patient” remembered things such as the ages of all their relatives, and at what age they died and from what causes. This was very different from my hospital visits! For the majority of my visits, the patients I talked to had a very difficult time remembering these details, and so, I was not able to include that information into my H&P.

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

I definitely see an improvement in my history-taking skills. In the beginning of the semester, I found myself struggling with the order in which I was asking the “patient” questions, and I would often miss some important questions that I should have asked. With practice, and through the hospital visits we had this semester, I was able to practice this skill, and I now feel that I have more of a flow, when interviewing patients.

• In what ways has writing an HPI improved?

I believe I improved in the way I organize my HPI. In the beginning I would struggle with organizing the information in a way where I included everything that was important and it made sense to the reader. I feel more comfortable with writing an HPI in a way where It now tells a story of what happened to the patient, and how they arrived at the hospital.  I am also aware of how important it is to be careful with my grammar in my H&P, and am trying to be more diligent with this.

• 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 a lot more comfortable with performing a physical exam compared to how I felt in the beginning of the semester. With practice, it has become a lot easier for me to do. Personally, I struggle with the time-frame I am given while on the hospital visits, as there were times when I felt rushed to go through the physical, after taking up a decent amount of time interviewing them. In those cases, I would attempt to do a more focused exam, and also practice the newer exams we learned in class.

• 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 would like to further improve my interviewing skills, and try to “dig deeper” while asking questions to my patients. Often times, if I talk to my patient long enough, I learn of more conditions/ disease states/ surgeries the patient had, and had forgotten to mention earlier. I want to become more comfortable with not taking the “surface-level answer” as the only possible answer from my patient. Also, I would like to learn to be a bit more comfortable with doing an entire physical exam while also on a time crunch. From my hospital visits, I noticed that I would forget perform certain tests in the physical exam if I was pressed on time.