My site evaluator for my Ambulatory Care rotation was Avital, PA-C at St. Francis Hospital. I presented H&Ps written up on patients I had seen at StatCare- an Urgent Care in Hicksville. During my mid-rotation evaluation site visit, my first H&P case was of a 57-year-old female who presented to the office with “cold” symptoms. Many of the patients at our clinic were presenting to the office with “cold” or “flu-like” symptoms, and I wanted to emphasize the population size that have similar health complaints in the winter months. For this case, I had various differential diagnoses from strep infection to acute sinusitis, which Avital agreed with. After my presentation, Avital mentioned that I should state the important positive findings first and I should’ve emphasized them while I speaking. During this visit, Avital asked me to include patient education in the assessment and plan which I incorporated for the 2nd site visit. As clinicians we’re not just diagnosing patients but offering ways to help patients achieve the best state of health possible through their own actions. Other cases I wrote about were otitis media and scabies rash. My site evaluator didn’t comment tremendously on my H&P as much as she critiqued my presentation, for example my voice and eye contact.
Also the other students that I presented with Cara, Merin and Toor who were rotating in Internal Medicine and Ambulatory Care shared similar interactions. It was nice to hear different cases and see what everyone was learning about. I was particularly interested in everyones technique in terms of presenting a case. I learned from Merin the importance of tone and eye contact, and how its imperative for the interest of your patients’ case to be taken seriously. Also from Toor, I learned how thorough and meticulous in questioning providers need to be such that we have accurate details on the accounts for the H&P which will help to determine most proper diagnosis.
Going forth, my plan for improvement is to make sure I consider all the pertinent positive and negatives, such that it gives my audience a quick overview of my patient’s case when I am presenting. I will incorporate the patient education in each one of assessments and plans in the future not only in my H&Ps but also in my patient interactions.