• Types of patients you found challenging in this rotation and what you learned about dealing with them

The type of patients I found challenging is the ones that are requesting unnecessary antibiotic. They will state a similar experience in the past and have received antibiotic from other providers. This is challenging because the patients believe that they are not being treated properly without the requested antibiotic prescriptions. In these situations, I would need to explain the indication and side effect of the antibiotic, and how antibiotic will not cure viral conditions. Explanation given to the patient as a PA student will be more difficult occasionally because the patients will prefer a “real doctor.” In this rotation, I have been observing how the other providers communicate and educate their patients. I will take my time and explain his or her diagnosis of the visit, the organism that might have caused her sickness, and the use of antibiotic and side effects. In addition, antibiotic resistance should also be educated due to the urgent threats to the public’s health. Patients are more receptive when they perceive professionalism and care from their providers.

• How your perspective may have changed as a result of this rotation (e.g. elderly patients, kids, IV drug users, etc).

My perspective has changed for kids as a result of this rotation. At urgent care, I have the opportunity to see more pediatric patients compared to my first rotation in family medicine. Pediatric population can be a lot more challenging compared to the adult population due to the fact that they are not able to provide a complete and reliable history. We have to rely on the parent’s perspective.  Pediatric population is also difficult because they can get easily distracted when they are being exam. They can be kicking around and pulling your stethoscope.  I have realized that when interviewing the pediatric population, skills such as communicating on the child’s level is important. For examples: learning the child’s name in advance, introducing yourself, physically getting down to the child’s level, or giving the child a helping role.  I would also acknowledge the child’s bravery as I interact with them and explain before I touch them. By getting more involved with the child will help to gain their trust and make my history and physical simpler to be completed.

• How could the knowledge I’ve gained here be applicable in other rotations/disciplines?

The knowledge I’ve gained here can be applicable in other rotation such as emergency medicine. In Ambulatory medicine, I have learned to assess the most acute chief complain from the patient. This is different compared to my previous rotation in family medicine, where all the chronic conditions will need to be monitored and assessed. I have learned to prioritize in this rotation. In a patient with acute abdomen and chronic knee pain from osteoarthritis, the acute abdomen will need to be assessed first because it should be prioritized over the chronic condition. This will be applicable in other rotations as well because knowing what is the life-threatening cause will help to arrange better quality of care for the patient.

• What do you want to improve on for the following rotations? What is your action plan to accomplish that?

For the following rotations, I would like to complete more procedures listed in the procedure log. In Ambulatory Care, I do not have a chance to complete procedures such as dressing changes, stable removers, and I&D. For my next rotation in surgery, I will be proactive in learning and observing these procedures. I will be asking for the opportunity to learn and perform these procedures. I would also like to practice doing more pelvic exams in the future rotations.

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