Browsing by Author "Pitre, Cory"

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    Diagnostic Reasoning Assessment Toolkit: Guided Reflection and Standardized Cases for At-Risk Final-Year Medical Students
    (Association of American Medical Colleges, 2016-07-21) Pitre, Cory; Emergency Medicine, School of Medicine
    Introduction: A failing diagnostic reasoning performance may represent student deficiency in a number of potential areas. However, many standard clinical skills assessments do not offer detailed assessments of diagnostic reasoning ability. This toolkit was designed to identify specific learner deficiencies with respect to diagnostic reasoning by focusing on individual student remedial work and by standardizing faculty evaluation. Methods: Educational objectives were derived from institutional patient care competency learning objectives at the Indiana University School of Medicine. Review of existing clinical skills remediation literature yielded a design that combined two learning methods: guided reflection and standardized patient cases. Results: Over the 2014-2015 academic year, 12 final-year medical students used this resource to help develop an individual remedial learning plan prior to retaking a failed standardized assessment. Students were generally satisfied with the combined guided reflection and standardized case learning methods. Discussion: Unique final-year medical student scheduling pressures, combined with a reporting time line for both institutional high-stakes OSCE remediation exams and the USMLE Step 2 Clinical Skills exam, incentivized failing students to schedule a retest on a short time line, often leaving little time for critical preparation. This resource offered an opportunity to efficiently spend limited preparation time to individualize exam preparation using a variety of faculty facilitators. The simplistic design was readily deployable to multiple faculty remediation mentors. Our institution can now provide a standardized diagnostic reasoning remedial evaluation using numerous clinical faculty based at any of our nine campuses.
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    Multi-Institutional Survey of Fourth Year Students’ Self Assessed Milestone Based Skill Proficiency and Faculty Expectation During an Emergency Medicine Clerk-ship: Implications For Curriculum Development
    (Taylor & Francis, 2018-09-13) Pettit, Katie; Turner, Joseph; Hogan, Kathryn; Poznanski, Stacey; Pfennig-Bass, Camiron; Kouyoumjian, Sarkis; Hexom, Braden; Perkins, Anthony; Pitre, Cory; Humbert, Aloysius; Emergency Medicine, School of Medicine
    Introduction: Emergency medicine milestones suggest skill performance expectations for graduating medical students. The objective of this study is to examine differences between student’s perceived proficiency and faculty expectations relative to Level 1 EM milestones, identifying opportunities for curriculum development. Methods: Using ACGME milestone language, the authors developed a survey that measures student perceived skill proficiency with 22 skills, which was administered to fourth year medical students at 6 institutions. Similar surveys were sent to faculty to determine their expectations of students’ skill proficiency. Differences between student and faculty responses were calculated. Results: There were 608 student and 114 faculty responses. There was a statistically significant difference between mean student and faculty responses for 13 of the 22 skills. For 10 of these skills, students rated their own skill proficiency higher than faculty expectations. For 3 of the skills, faculty rated their expectations higher than students’ perceived proficiency. Conclusions: For pharmacology skills, student ratings were low, indicating an area to focus curriculum development. Items where student ratings are higher than faculty may be a result of overconfidence or a lack of understanding by faculty of students’ abilities. Formal assessment of skills in these areas would help clarify the reason and direct faculty and curriculum development.
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    Negotiating Work-Life Integration
    (Association of American Medical Colleges, 2017-09-05) Pitre, Cory; Ladd, Lauren; Welch, Julie; Emergency Medicine, School of Medicine
    Introduction: Integrating work and home domains is a constant challenge for medical professionals. Only half of physicians report positive work-life satisfaction, implying that negotiating the inherent conflicts between work and home may not be intuitive. Early teaching of skills focused on professional sustainability may best prepare physicians to navigate conflicts between work and home domains. Methods: This interactive workshop targets trainees and junior faculty. It aims to highlight the current state of physician career satisfaction, to bring awareness to the risk of physician burnout, and to apply strategies that promote work-life integration as a lifelong practice for sustained career satisfaction. It includes a detailed presentation with structured resources to reinforce skill development. Results: This workshop was delivered five times to trainees and junior faculty. Workshop evaluations (n = 50) revealed that all participants believed the information presented was useful, addressed competencies relevant to their training, and increased their knowledge about how to create better work-life integration; all anticipated improvement in their professional work. They all recommended this program to a colleague. Discussion: This workshop offers an effective way to teach a skill set that enhances physicians' abilities to negotiate conflicting work and life domain boundaries. Our results indicate that learners intend to apply newly acquired strategies for work-life integration so as to improve career satisfaction and wellness. Such skill sets may mitigate physician burnout and promote career sustainability, both critical issues with far-reaching implications for the delivery of safe, high-quality health care at the provider and system levels.
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    Physician Time Management
    (Association of American Medical Colleges, 2018-02-14) Pitre, Cory; Pettit, Katie; Ladd, Lauren; Chisholm, Carey; Welch, Julie L.; Emergency Medicine, School of Medicine
    Introduction: Time management is an essential skill set for physicians. The importance of time management is not routinely emphasized in undergraduate or graduate medical education curricula, often resulting in the development of poor time-management practices early in training. Improving time-management practices may lead to decreased stress, increased productivity, and improved well-being for physicians. Methods: This interactive workshop targeted trainees and junior faculty. It aimed to highlight common physician knowledge gaps with respect to cognitive limitations and to teach effective time-management strategies. It also aimed to educate learners about how time management may increase physician career satisfaction. The workshop included a detailed presentation with structured resources to reinforce skill development. Results: This workshop was given four times to 54 residents in two different training paradigms. Evaluations were based on a 4-point Likert scale (1 = Strongly Disagree, 4 = Strongly Agree). Overall, participants indicated that the workshop addressed an educational need (M = 3.72) and would recommend this workshop to a colleague (M = 3.83). Follow-up survey results at 4 months indicated that most workshop participants had noticed some degree of improved productivity and well-being, that only a small minority had not incorporated new elements of time management into routine practices. Discussion: This workshop offers an effective way to teach time-management strategies to physicians. Our results imply that this workshop meets an early career physician need by addressing a necessary skill set. Effective time-management skills may promote physician career sustainability.