It's always taken me a long time because I'm a slow (but thorough) learner. - sm

But it gets harder and harder the older I get.  You have my empathy.

Do you use "cheat sheets"?  And sample reports?  I bold areas in my samples that I want to stand out that I happen to do differently from what the VR constantly puts incorrectly. And I also use cheat sheets similar to the below rather than keep the Client Specs up to dig through constantly (formatting strangely here; I keep font as small as I can stand and single-space, using Wordpad, and also color code actual transcribed phrases, etc.).  I only notate that which is different from what is standard/automatic for me. 

For example (Cheat Sheet for 1 account):

Abbreviations: verbatim (bicarbonate back to bicarb)

Addendums: Addendum, not ADDENDUM. Pend to ____:  

Allergies: Cap whole phrase. PENICILLIN CAUSES A RASH.

Ampersand: None.

Arabic/Roman: All Roman except for grade and type.

Blanks: Two. (3 or more, pend to ____:)

Carbon Copies: Match business entity.  

Commas: No serial comma.

Continuations: Pend to ____:

DATES: As dictated (OR "leave formatted date alone, as long as correct"). Force 4-digit year: 11/27/2012    Preop: Use date of surgery for Date of Service field.

Department Names: Cap when an entity (referred to Cardiology), not otherwise (referred to us from cardiology department). Emergency Room/Department always.

HEADINGS: Start on same line, unless paragraphed subheadings (one below). Subheadings paragraphed, no forced headings, narrative okay.

Incomplete: Pend to ____:

LISTS: Do not enumerate unless dictated.  Meds: Stacked, enumerated or not.

Medication abbreviations: DO NOT abbreviate (per Style Guide).  HCTZ = hydrochlorothiazide

Military time: No "hours."

No Dictation: Pend to ____:

Patient Name: No patient names (= The patient...).

Ranges: Use hyphen.

subcu: subcutaneous/subcutaneously only (no subQ)

Worktypes: DO NOT CHANGE if incorrectly keyed. Pend to ____.

I feel your pain. - Slow learner.