Writing H&Ps was very difficult for me at first, since I had absolutely no prior experience writing one. When comparing my H&P from before to the one uploaded recently I am able to see the improvement. The second H&P had more pertinent negative and positives and there were less extra words. I noticed my history taking skills had improved as well, and I was able to elicit all the relevant information for my patient’s complaint. By doing so my H&P was stronger and it painted a good picture for the reader. Overall, I feel that once I was able to understand which pertinent negative and positives were associated with certain conditions, it became much easier to ask related questions, which in turn allowed me to write a better H&P. I would still like to work on the ROS until I can ask every question from memory.
During the physical exam the problem I am faced with the most is getting nervous when being watched or analyzed by someone. When I am alone with my patient the exam usually goes smoothly. However, when I am with someone my flow of examining the patient is not the same. I am confident that with time and practice the nerves should disappear. Other than the nerves most parts of the physical I am comfortable with such as checking the vitals, HEENT, abdominal exam, and extremities. Some that are more difficult at the time are eyes, pelvic, and heart exam. I am especially weak at identifying abnormal heart sounds and definitely need more exposure and practice. During my clinical year I would like to strengthen my skills in doing a pelvic exam as well as listening to heart sounds.
