During my first site evaluation I was extremely anxious about how I would perform and what to expect in terms of feedback. At arrival to the evaluation we were pleasantly greeted by our evaluator who then continued with a mini session on the important aspects of a good presentation, which we appreciated very much. We each presented one H&P during which she stopped us to ask about our understanding on certain tests, and abnormal physical exam findings. My presentation was on a patient that I had encountered that same week. Rotating in an urgent care setting I mostly encounter patients with complaints such sinusitis, influenza, UTI’s, and a few others. The patient I chose to present came in with a complaint I had not yet encountered during my rotation. He presented with an acute flare up of diverticulitis making it a more exciting case to work with. During this encounter I learned so much about the disease process and how to manage it in an out patient setting such as an urgent care. 

    Our Evaluator explored why we chose certain treatments plans for our patients and if we understood the pathophysiology behind the disease they presented with. This part of the evaluation helped me realize how much I really understood about the disease process and the treatment plan I chose. She then allowed us to ask questions on parts of the presentations we thought we were weakest in and took the time to give us tips on what to focus on and how to become stronger in those sections. She also touched on the importance of patient education and how we must include it for every patient encounter. I had printed out the whole up to date basic patient education handout for my H&P, but she explained it would be acceptable to just touch on the most important points so that the patient does not become overwhelmed with information. We agreed that we can give the handout to the patient to read at home, but before they leave the office we must educate them one on one. Aftercare education should include things the patient must do to help the healing process and also things they must avoid to prevent worsening or reoccurrence of the disease. 

    For the final evaluation I chose another unique patient encounter we had at the urgent care. This patient presented with a spontaneous PTX. The evaluation process was the same except this time we had the addition of pharm cards and a journal article relating to our patient. Ultimately our evaluator stated I had done a great job with both of my presentations and she was very pleased being that it was my first rotation. 

    One thing about this evaluation process I really enjoyed was presenting alongside two of our classmates who were rotating at Internal med instead of ambulatory care.This allowed me to see the difference between the patient population they encountered and how their approach to writing the H&P was different then mine. Most of the patients they were presenting had many medical conditions making their H&P’s a bit more complicated and the treatment plan more extensive. Both of them did a great job with their H&P’s and I was glad I had the chance to hear them present. After this experience I realized that during each rotation I will need to adapt to writing H&P’s for the different patient populations. I really hope to get more comfortable with patients who present with multiple comorbidities and would like to become stronger in developing plans for such patients.

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