My site evaluator for this rotation was Mr. Ronald Combs. During my site evaluations, I presented 6 SOAP Notes and 1 H&P. I was offered constructive criticism about formatting my notes in a more concise fashion, including pertinent information, etc. Mr. Combs also advised me to continue reading and improving the “Assessment/Plan” portions of my notes. As I had mentioned in my “Reflection,” I felt that this was one area that was challenging for me, as the needs of surgical patients stray from those of Emergency Medicine patients (my first rotation). These patients require plans for pain management, diet, etc. Additionally, documenting appropriate prophylaxis (DVT, etc.) would be important for me to consider in the future. I presented SOAP notes on patients that had Colorectal Cancer, Diverticulitis, Small Bowel Obstruction, etc. These SOAP notes included documentation of the patient’s pain, diet, and other pertinent findings. Particularly, Mr. Combs advised me that when writing SOAP notes, it wasn’t necessary to include sections for PMH, PSH, Social Hx, etc., unless they were pertinent. Mr. Combs acknowledged that I performed the appropriate physical exam and documented my findings correctly. For my H&P, I presented on a patient that was diagnosed with Rectal Cancer. Mr. Combs was pleased to find that I had performed and documented my findings from a rectal exam.

I also presented a journal article related to Colorectal Cancer. This article discussed the epidemiology, presentation (signs and symptoms), risk factors, and preventative measures for Colorectal Cancer. I summarized the key points from this article, and we discussed interesting components like the difference in CRC presentation depending on lesion location.

I also presented several Pharmacology cards related to commonly used medications in General Surgery. These included Vancomycin, Alvimopan, etc.

One of the things I enjoyed about my site evaluations was that Mr. Combs wanted to “hear my story” about who I am, why I chose to become a PA, etc. He offered me a great deal of advice and motivation to advance my career in the future. We have planned to meet during my next rotation at NYPQ so he can see how I am progressing (in regard to writing my SOAP notes, clinical knowledge, etc.).

Going forward, my action plan to improve is to get more feedback regarding my SOAP notes, H&P, orders, and other documentation. The more I work on these assignments and the more feedback I get, the better I can become as a clinician.