For the first evaluation, I presented a case involving a female patient who visited the emergency department for gallstone pancreatitis. As I was writing up this case, I had to do some background research on pancreatitis, including relearning what it was. This really helped me expand my knowledge in the area. Before completing this evaluation, there was still so much about pancreatitis that I didn’t know. After researching, I learned a lot, not only about pancreatitis but also about gallbladder diseases. During the didactic phase, I honestly didn’t know enough to distinguish between gallbladder diseases, but now I would say I finally feel comfortable and knowledgeable enough. To enhance my understanding, I watched a helpful video on Osmosis that clinically discussed pancreatitis. I also used UpToDate to learn about management and the differential diagnosis for pancreatitis.

For my second evaluation, I discussed a male patient who had osteomyelitis. I saw an ulcer that went straight to the bone. This was another topic that I didn’t fully understand during the didactic phase, and it was astonishing how much can be learned by researching a topic related to the case. I learned the importance of managing diabetes to prevent foot ulcers, especially because they are so linked to osteomyelitis. To my surprise, I didn’t know that so much was involved with osteomyelitis; I thought of it as more of an independent disease. But to prevent ulcers, you need to keep the area clean and manage diabetes at the very least. Therefore, it is important to make sure that everything is controlled to prevent future ulcers. I made the mistake of focusing too much on osteomyelitis only and not thinking about the big picture, which includes controlling risk factors. Therefore, management involves not only the disease in question but also everything else that surrounds it, and that’s a lesson I will take with me into future rotations.

In the second evaluation, I also presented an article related to bone probing and its accuracy for diagnosing osteomyelitis. I learned that it is a useful part of the physical exam because it has sensitivities and specificities similar to MRI and ESR measures.

This evaluation was a good learning experience because I made several mistakes that are worth learning from. First, I need to work on my H&P flow, making sure it includes the relevant information and doesn’t become too repetitive. Second, I really need to make improvements to my plan, ensuring it includes all necessary steps, including consultations that need to be made. The plan also involves managing everything else that needs attention regarding the patient’s health, whereas before, I thought the plan was only for the patient’s chief complaint and related diagnosis. There was plenty I was unaware of and need to improve on in the future to be a competent physician assistant. But I am glad I am learning and finding out now while I’m still a student. I look forward to the next rotations to continue learning and improving my skills.