you've had great advice so far.
mistakes I have seen made:
- trying not to disturb a patient who is in fact unresponsive. "He's just drunk" is not an excuse not to keep re-examining a patient. You need to get this information. The first time you go in the room, do what needs to be done - try to wake the patient up with voice, loud voice, tapping on shoulder, sternal rub if you have to. You will look kinda silly if you go back and say "He was asleep, so I didn't get much of a physical exam." no, do it!
- getting the H&P but not the physical exam. I've even seen 4th year students do this. "She said she had leg pain" "What was the leg exam like?" "I dunno, I haven't learned how to do a leg exam yet." That's a little sad. At least look at the body part in question, palpate it, give it a range of motion. You don't need to 'learn' how to do that.
so in summary, before you leave the room, just ask yourself "did I do a good HPI (CODIERS, you want a level 5 chart with all the HPI elements and a quick fire review of systems that hits 10 systems), did I do a good exam including specific exams of whatever is related to the patient's complaint - i.e. do that rectal if the pt is complaining of blood in stool, do I have at least 3 DDx items starting with most life threatening DDx possibilities? That ought to start you off well.
- I would reiterate what the previous poster said about pushing to make sure your patients get pain relief and anti-emetics as soon as possible. I know it is a bit frustrating when you are a student and can't write orders, but making your patients comfortable is important and you don't want to leave them writhing on the bed while you go through a long presentation or barfing their guts out.
hope I don't sound too harsh, I am really nice to medical students but you don't wanna be the one making rookie mistakes.
any further questions just ask.