Reflection

Comparing my HPI notes from PD I and PD II demonstrates growth in my clinical reasoning, organization, and confidence as a PA student. During PD I, my approach towards patient-care was obtaining a detailed history and completing an extensive review of systems, thus losing focus on the pertinent information needed to diagnose and treat the patient. Although my work reflected my attention to detail, I found it challenging to form a clear consistent assessment and plan due to the abundance of information I obtained. It was also difficult to understand which specific physical exams and special tests were necessary to conduct to rule in/out my differential diagnoses. 

In PD I, my H&P focused on a seizure presentation, requiring a broad neurologic history, detailed order of events, and consideration of a wide differentials, including metabolic and medication-related causes . In PD II, my H&P on biliary colic demonstrated more focused clinical reasoning, with targeted abdominal history, risk factor assessment, and physical exam findings that directly supported a narrower differential. The biliary colic case reflects improved prioritization and clear connection between symptoms and pathology.

One of my strengths that developed over time was my ability to connect patient history, physical exam findings, and diagnostic reasoning into a focused clinical presentation. I also became more comfortable performing and documenting advanced physical exam maneuvers and interpreting results. Additionally, my assessment and plan in PD II reflected greater confidence and utilization of evidence-based medicine.

I want to continue to improve in creating a concise assessment, pointing to a specific presentation that is easily identifiable and becoming more confident in providing anticipatory guidance and patient education that the patient can easily understand. Moving forward, I strive towards improving efficiency, clarity, and confidence while maintaining a patient-centered approach.

Overall, my upward progress from PD I to PD II reflects meaningful growth in both my technical skills and clinical judgment, preparing me for increasing responsibility during clinical rotations and future practice.