Practical Exam Reflections

Practical Exam 1

During the first part of the exam I was asked to needle a few specific points and then needle a few more and say what they were. I had gone over my point locations for all the most common points but being a brand new intern my idea of common points was different than the text creators. I was able to find one of the two and I was able to pick two more but the fourth was indeed a “common point” but I hadn’t yet come to know it as one: SanJiao 6. What I learned from this was to push myself and my supervisors to include more points in my prescriptions and not just rest on what I know best.

In the second part of the exam we were taken to a treatment room and asked to do an intake and assessment of a patient with only the information that they had a cough. I remember just telling myself to do every physical exam having to do with the lungs, which I did. I also asked her if she suffered from acid reflux, to which she said yes. I felt lucky at that moment because it was only through my personal relationship with someone who suffers from acid reflux that I knew it could cause a persistent cough, especially at night and when laying down. This was the first time I realized how essential our personal relationships and experiences are to our knowledge bank.

In the final portion of the exam I was taken into a new room for charting. This was by far the most difficult for me. With a time restriction of 30 mins I felt like I could never complete everything I needed to do. My first mistake was not trusting my instincts and charting that her acid reflux was part of her diagnosis, though I did include it in my SOAP notes. My second mistake was not checking the clock until I only had 5 minutes left. At that point I still had to complete my whole point prescription, which at the time I was still very new at. I quickly wrote down what I could and finished with a complete intake form. I learned two things from this final part: one, trust your instincts. With a solid foundation in diagnostics you can and should always trust your instincts. Two, time management, always keep an eye on the time. This extends past charting of course and is endlessly useful in all aspects of treating.

Practical Exam 2

                The first part of the exam tested me on my physical exam skills. It was straight forward and went as expected. I don’t feel like I learned anything new or useful during this part. The second part of the exam was much more interesting and complex. I was given a patients chart that had been coming for a few sessions and had provided some new blood work which he wanted me to explain to him. In essence the CBC and previous charting indicated that the patient was over consuming alcohol and Tylenol and it was affecting his liver. The job presented in the exam was to analyze the information and explain it to the patient in a way that was both within our scope of practice and also in a way that would not offend the patient. Having been in clinic at this point for about a year and also having been in the service industry for 4 years served as a great source of confidence and assistance with undertaking this difficult task. Something my proctor said during my review that stuck out to me was that at one point I was too casual with my word choice. Though I am glad to have my background in the service industry and feel it serves me every day, I do need to continue refining my professional diction. The other thing that was pointed out to me came from my “patient.” He said that while I was explaining the CBC he would have liked to have been looking at it with me. He felt like he understood less and would have retained less without looking at it with me. This was especially interesting to me because I’m also a visual learner and therefore I would have appreciated the same thing from my practitioner. It’s always best practice to try and remember how you would like to be treated when treating a patient. It will also make you a more humble and empathetic practitioner.