Nate,
I started out on V.6 non-medical about 8 years ago and went to 10.1 Medical about 8 months ago. I use templates in the PE section and freely dictate my HPI and Plan. Using commands is essential. For changing sections of dictation or a few words, I recommend the comman "select" and then the word or "select from (choose word) to (choose word)" and the entire phrase will be selected and can then be replaced. The "insert after" or "insert before" command is also handy for putting the cursor wherever you want. The accuracy is amazing and most people can't type that fast. You can also use a "macro" to store a phrase or paragraph that you consistenly use and drop it in anywhere (i.e. recommendations, side effects, risks, warnings, entire procedure notes,etc.). I can't imagine doing notes without it, though the initial training may take the software 1-3 months to really be great.
Steve