What differences do you note between the two H&Ps?
I noticed that my H&P was more detailed and reflected all the pertinent negatives and positives for the diagnosis at hand. I was also able to seamlessly incorporate OLDCARTS into the HPI, so that it is easy to read and flows. 

In what ways has your history-taking improved? Are you eliciting all the important information?
I think I am able to converse with the patient to obtain a history rather than trying to check off boxes of things to ask. I think it is important to have a foundation of clinical knowledge so that you know what symptoms are important to ask about. Additionally, it is important to consider a patient’s past medical history when asking certain questions because a healthy person with a certain diagnosis might have a different treatment plan than someone with underlying conditions.

In what ways has writing an HPI improved? (hint: look at the rubric scores)
I have made to write “none” instead of “N/A” when there is nothing for a certain section of the H&P. Writing N/A might be confused for “not asked.” Additionally, I’ve been able to write an HPI using OLDCARTS to make sure it is flowing seamlessly. 

What is your self-assessment of your current skill in performing a physical exam? Which areas do you feel strongest about/weakest about?

I feel confident in abdominal, heart, and lung exams. Neuro exams are more difficult because you have to mentally note which cranial nerve you are evaluating for, while conducting the exam without breaks. Musculoskeletal exams are also focused to a certain body part but it is sometimes challenging to remember each of the rotator cuff tests on the spot.

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 will make sure to have an idea of which physical exam should be done based on the chief complaint and brush up on my skills so that I don’t forget to conduct any important part of the physical.