The differences between the two H&Ps I posted show my progress and how I am beginning to understand it. There are better organization, especially in the HPI. I believed I am more confident when interviewing the patient, hence I was able to ask important questions pertinent to the primary patient’s concern. I also have a clear understanding of the pertinent positive and negative, while reflected a much fluent HPI. In regard to my current skills for physical exam, I still need to work on the speed for lungs and heart; I am sure that with more practice I will eventually achieve my target timing. I still need more practice on physical exam for lungs and heart in order to identify faint crackles, rales, rhonchi, or wheezing, murmurs. I will hope to write more SOAP notes to be more familiar on the assessment and plan part. The search for differential diagnosis became more easier for me as my medical knowledge increased. My plan for clinical year is to have daily practice on focus H&P, concise physical exam, and a better flow during patient interview. Being a good observer to distinguish between normal and abnormal patient presentation and how to related with the patient’s chief complaint.
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