For my first site evaluation, I presented a patient that came to the family practice because he was having right lower extremity pain and swelling. Even though this presentation could have been as simple as a gout exacerbation, the patient was found to have tachycardia, up to 140 bpm. Though a practitioner could assume the tachycardia was secondary to the pain the patient was experiencing, a DVT could not be ruled out. This patient was then sent to the hospital for further evaluation. I chose to present this case because it was a little more interesting to me. While I was presenting, I tried my best not to read off of my H&P, however, I kept glancing at my paper, and making it even worse, I did not articulate the patient’s symptoms in the order they should have been presented in. After I was done presenting, I got two major points of feedback. The first was that I did not describe the localization of the pain and swelling properly on documentation, I was not specific enough. I should have included, medially or laterally, anterior or posterior, and so on. The second point of constructive criticism I received was that while presenting, I said the pertinent negatives, which is very unnecessary. Until this point, I was very confused on whether or not I should be presenting the pertinent negatives, just because in my head, I would what to know if something is normal, just so I can start to rule out a certain diagnosis. However, the evaluator explained why presenting the negatives was unnecessary in most cases. Then I presented my pharm cards, which was pretty standard. I, of course, did not know all my pharm cards all the way through, but I knew about eighty percent of the information on each pharm card. I learned that I should be spending more time studying pharm cards.

For my second site evaluation, I presented another interesting case where a 23-year-old male complained of chest pain and shortness of breath, but it was found to be psychosomatic because the patient admitted to trying to harm himself the week prior. With the previous comments that I received from the last evaluation, I kept my case presentation very simple and sweet, only including the pertinent positives. I also glanced at my H&P only when necessary, which allowed me to keep eye contact with my evaluator as well as look more confident when presenting. One of the feedback’s that was provided was that more could have been done as a treatment for the patient, for example, a chest x-ray to rule out any lung abnormalities. I then presented my article that was based on Family Dysfunction in those with Chronic Localized Pain and Chronic Widespread Pain. I had written down the points that I wanted to touch upon during the presentation, so I read off my list of what I thought was most important in the article. My preceptor seemed to be interested in the article and she questioned some of the conclusions that were made in the article, all of which was within reason. I finally presented my last five pharm cards, and I had seemed to make the same mistake as my previous site evaluation. I did not study my pharm cards enough, and my evaluator was generous enough to give me hints to help me remember some of the information. I know from now on I will study more for my pharm cards, because they are something that should be taken seriously, considering that the PANCE is not too far away anymore. Overall, I felt that my site evaluator was more than fair and was very willing to answer any questions that the students had.

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