Wednesday, March 12, 2008

Progress Notes

Today was a pretty good day. Our PBL group was finally at full strength, and the session went well. I haven't worked with several of the people in my group before, and there are a couple of others whom I haven't worked with since the beginning of last year. The people who were here on Monday decided that they wanted to try having discussions of learning topics rather than formal, presented learning objectives. I was a little skeptical about that, because one of my previous groups had tried it, and it wasn't very successful. We never got a good discussion going, and after a week or two, we went back to the formal presentations. But this group is different. I think it's in large part because most of us are talkers. Not only did we have an excellent discussion, but there were actually points where people were talking over one another. That's not ideal either, of course, but it's loads better than everyone sitting around staring at each other.

Our seminar was good too. We were divided into groups of eight for a tutorial on different kinds of diseases of blood cells. I thought our leader did a really good job. After the seminar, I was watching the physical diagnosis video because I thought I'd have to do another full H & P for my second acute care session, which was this afternoon. But I wound up spending most of the time learning how to read the patient's chart. Unlike the outpatient clinic patients, the hospitalized patients at the Cleveland Clinic still have paper charts. Part of their records are online in Epic as well. Epic is pretty cool once you get the hang of using it. My patient had some chest x-rays, and I could pull them up on Epic and take a look at them. His EKG was not online though, so I had to look in the paper chart for that. The other thing that my preceptor worked on with me was to write the assessment and plan portion of the progress notes. I have not really been doing too much of that in the outpatient clinic, so it's noticeably the weakest part of my SOAP notes.

My last acute care clinic session is on Monday. These sessions have really been super helpful. I am not sure how the faculty preceptors would feel about it, but it would be great if we could do even more of these hospital sessions, maybe in place of some of our outpatient clinic sessions. There are so many things to learn about in the hospital setting that any little bit extra would help us make the transition to the wards in July.

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