HPI Reflection:
What differences do you note between the two H&Ps?
From my first HPI to my last one, I learned more about where the information I obtain from the patient belongs. In my first HPI, I added some irrelevant information such as the patient gaining weight due to stress. In this specific situation, it wasn’t relevant and didn’t belong there. Also, in my physical exam section, my general survey didn’t include everything that it should’ve. I improved on these as I wrote more H&Ps.
In what ways has your history-taking improved? Are you eliciting all the important information?
My history-taking got better because as I saw more patients and practiced writing more H&Ps, I noticed that I began asking more relevant questions. The sim sessions also helped me with this because they allowed me to practice going through OLD CARTS with different scenarios. I also made sure to go through all past medical history, family history, current medications, and any known allergies.
In what ways has writing an HPI improved? (hint: look at the rubric scores)
My HPI improved in many ways. According to the rubrics, I went from including 5-7 components of OLD CARTS in my first HPI to including all of the components in my last one. My HPI also is written in a more flowing way in my final HPI which allows the reader to be able to easily comprehend.
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 my physical exam improved from my first hospital visit to my last. I had more knowledge but my confidence also increased and that allowed me to perform it better. I feel confident with the vitals, general survey, head/skin exam, and abdominal exam. However, the heart and lung exam is still a little difficult for to determine if it is normal or abnormal. I am able to pick up on obvious sounds of wheezing during auscultation, but it is more difficult with sounds that aren’t that obvious. I believe with more practice I will feel more confident.
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 believe my confidence improved but I still need to work on being more confident when I am with the patient. Also, rather than trying to checklist to make sure I get all the information, I should allow the information come to me through my conversation with the patient. At the end I can check to see if I missed any important information and add it in.
