Looking back at my H&Ps from PD 1 and PD 2, I can clearly see how much I have improved in history taking and formulating my differentials as a PA student. In my PD1 H&P, my goal at the time was to be as thorough as possible with an emphasis on completeness rather than interpreting the information. At that time, I had not yet learned how to formulate a prioritized differential diagnosis. When comparing both H&Ps, I can see a clearer shift from simply completing all components of the H&P to tailoring my history-taking questions towards a suspected diagnosis. Additionally, my physical examination in PD2 was broader and more focused. As a result, I able to develop assessment plans and order diagnostic test aimed to rule in or out diseases/conditions that I felt were clinically pertinent.

As I continue to progress thought PA school, I aim to further improve my history-taking skills. Currently, I tend to approach patient histories in a systemic order. Moving forward, I would like to improve my ability to tailor review of system questions to my differentials. As I find this approach to be more organized, efficient and clinically effective overall.