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HPPA 502 & 522 (PD Lab) – H&P with reflection



Upon comparing my first and last H&Ps, the first thing I noticed was the well-organized structure of my initial HPI, whereas the latter one appeared somewhat disorganized. I believe this difference stems from my first H&P having a more chronological flow, whereas in the third one, I encountered difficulties in determining where to start. As a result, my first HPI received a grade of “excellent,” while the third HPI was rated as “good” due to missing some components of “OLDCARTS” during the write-up. For future reference, I need to ensure that my HPI flows coherently, making it easy to understand and containing only the relevant information. I recognize that my history-taking has improved, as I have begun asking for more details, striving to gather as much information as the patient is willing to share, to gather a comprehensive history. For instance, in my third H&P, I made sure to inquire about the patient’s living situation and whether anyone witnessed their fall and assisted the patient in getting back up. This level of attention to detail was not something I practiced in my earlier H&Ps. Concerning my ability to perform a physical exam, I acknowledge that it remains a work in progress. I find the fundoscopic exam particularly challenging, as I still struggle with using the ophthalmoscope. Additionally, I do not feel entirely confident in identifying abnormal lung and heart sounds. However, with additional practice, I am certain that I will be able to perform a thorough physical exam without any issues. I expect to become more proficient in all aspects of the H&P, however one area of particular focus will be the efficient use of time for completion. In the real clinical setting, time with the patient is unfortunately limited, causing clinicians to use their time wisely. With more practice and repetition, I am confident that I will be able to complete an H&P much more quickly than I currently do.