HPPA 552 CC – Final reflection

From beginning to end of clinical correlation sections, I have developed a good history taking skills. According to patient’s chief complaints, I am able to have more complete HPI and including pertinent positives and negatives. Also, I am much better at developing differential diagnosis, and know what focused physical exam, labs, and image study are needed for the patient after taking history. I found out it is a little hard for me to get patient’s consent, like before the procedure, how to explain to the patient that the worst result of surgery’s is death, but it does not happen most of the time. During the clinical year, I still need to work on patient management and developing treatment plan. I hope I can get a lot of hands on experience, especially physical exams and interactions between different patients, especially how to re-direct patients back to topic when they are talking too much about something else, and how to take detailed sexual history without feeling embarrassed.

During the clinical correlation sections, the most often site I used for the topics is Uptodate, which I think is really helpful. In addition, I also check Medscape, Pubmed, and algorithm form textbook. For screening guidelines, I often check USPSTF and ACA. It is important to stay in current with guidelines and offer screening tests to appropriate patients. In the clinical year, I think I will keep visiting these sources for any topics that I do not know. I will advise students in the class behind me to remember that, do not jump to conclusion before you have detailed history, physical exam and labs done. Get broad differentials first, and with those differentials in mind while asking patient more questions, then narrow down. There are many possibilities, some history or physical exam findings can lead to different directions. Again, diseases do not read the textbook, so keep atypical presentations in mind as well. It is really good to rotate with different professors, because each professor works in different specialty and they provide different cases types, and I learn a lot from these cases.

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