My emergency medicine site evaluator was Andrea Urgiles. In total, I submitted eight focused H&Ps, ten pharm cards and a journal article with a summary. During the first evaluation, I presented one focused H&P and reviewed several pharm cards. We discussed the importance of patient education, regardless of whether the patient is being admitted or discharged. Even though I never wrote patient education before in a H&P, I found this extremely beneficial as it helped me think about how I would explain the condition or the disposition to the patient. This allowed me to focus on the pertinent results and findings that should be explained to the patient, and what additional information, such as pain medication, rest etc., should be emphasized. I received feedback on how to write this education, which I appreciated because this was new to me, especially since the education is often pre-written in the EMR, so going through it myself was a learning experience. Additionally, it was beneficial to write the differentials for the H&Ps, even if I already knew the admitting or discharged diagnosis, because it allowed me to think through the important and life-threatening diagnoses that cannot be missed in the emergency department. On my second evaluation, we also discussed the importance of writing how the patient arrived to the ED (by foot, EMS, mass transit etc.) as this may provide further insight into the severity of the condition.

During my second meeting, I presented a review journal article on lacerations, as I saw various techniques and methods being used during the laceration repairs I participated in. I wanted to read on current recommendations and managements into multiple facets of laceration repair, such as sterile versus nonsterile gloves, non-absorbable versus absorbable sutures and whether other anesthesia such as topical anesthesia should be administered prior to subcutaneous anesthesia injections.

My site evaluations for my emergency medicine rotation were beneficial, as they provided me with further insight into what additional information I should include in my focused H&P. I felt comfortable with these focused H&Ps, as this was my previous job as a scribe in the ED, and I felt I was able to greatly expand, now from a future clinician point of view, on the pertinent details to include. Going forward, I plan to work on my patient education so that I can adequately convey the diagnosis to the patient and continue to keep a differential list, so I know why I am ordering certain blood work or diagnostic imaging.