- What differences do you note between the two H&Ps?
The first H&P is less detailed, and also copied much more verbatim. My second HPI is stronger, with mention of notable findings and other past medical history with more detail. My second also has a differential and more detailed physical exam.
- In what ways has your history-taking improved? Are you eliciting all the important information?
I’ve gotten a lot better on focusing on what is most important to ask, like the “must-haves” and how to make sure you have the time to get them. In my first H&P, every single thing was critical, but that lead to me asking a lot and running out of time to cover it all. I also have been able to memorize more of the history taking, so I’m less reliant on following a format and looking at my notes to see what is next.
- In what ways has writing an HPI improved? (hint: look at the rubric scores)
I’ve gotten better at including all of OLDCARTS, which was really hard for me to remember initially. I also have gotten better at the physical exam–not only being able to do more things but also being able to recognize findings and know what to write about them.
- What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?
I think without COVID I would’ve felt great overall. At this point, I’m definitely stronger than when I started, and I’m able to cover critical parts of the physical exam. I feel strongest about HEENT, and probably weakest about cranial nerves and the reflex/strength tests. Everything else is kind of in the middle. However, it’s been a while since I’ve practiced and so I know there are many small things I would probably forget. I feel more confident around patients as well.
- 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 have a goal to be as close to perfect as I can be for cardio, pulmonary, and abdominal because those exams are critical. While all parts of the physical exam are important, those tell you a lot and I want to be able to do those every time with ease.
