Louis N. Pangaro

MD, MACP

Department of Primary Appointment:
School of Medicine
Medicine
Title
Professor of Medicine
Location: Uniformed Services University of the Health Sciences, Bethesda, MD
Research Interests:
Medical Education
Faculty and Leadership Development
Office Phone

Education

Georgetown University Medical School, Washington, DC - M.D. 1973
Internal Medicine Residency Georgetown Univeristy Hospital 1976
Fellowship in Medicine, Endocrinology, Georgetown University 1976-1977
Chief Resident, Department of Internal Medicine 1977-1978
Fellow in Endocrinology, Department of Medicine, Walter Reed 1980
Stanford University Faculty Development Program 1987

Biography

Dr. Louis N. Pangaro is Professor of Medicine at the Hebert School of Medicine of the Uniformed Services University of the Health Sciences.
His medical degree is from Georgetown University (1973), where he also did a residency in Internal Medicine and fellowship in endocrinology. He was a research fellow in endocrinology at Walter Reed Army Medical Center, and develop a radioimmunoassay for 3,5 Diiodothyronine. Dr. Pangaro joined the Uniformed Services University in 1978, with positions as Director of Fourth Year Programs, Clerkship Director and Vice-chair for Education. He was appointed Professor with tenure, in 1998. He was served as Department Chair from 2008 to 2018. Since 2009 Dr. Pangaro has been one of the faculty leaders of curricular redesign for the USU School of Medicine.
Dr. Pangaro's scholarly work is in the evaluation of the competence of medical trainees and has published more than 100 articles relating to medical education. He created "standardized examinees" to calibrate the validity of the prototype clinical skills examination of the US Medical Licensing Exam. He introduced the concept of "synthetic", developmental frameworks for defining expectations of students and residents (the "RIME scheme", for reporter-interpreter-manager-educator) that is now used in EPAs and milestones. The RIME alternative to the traditional knowledge-skills-attitudes paradigm is used in many American medical schools.
Dr. Pangaro has personally evaluated and given individual feedback to several thousand medical students. Nearly all of them are still part of the military medical community. As a facilitator in the Stanford Faculty Development Program he has worked with more than one thousand military faculty on their teaching skills. Starting in 2000, Dr. Pangaro created a six-day course for military GME program directors in assessing competence, and nearly 300 program directors have participated in the last decade. He has published and spoken widely on faculty development and leadership in medical education. He co-directs the annual Harvard Macy International Program for a Systems Approach to Assessment in the Health Sciences Education. His department has initiated an MHPE and PhD program in medical education.
Dr. Pangaro has served as an at-large member of the National Board of Medical Examiners, and on the editorial boards of Academic Medicine and Teaching and Learning in Medicine, and is past-chair of the Research in Medical Education Conference Committee of the GEA/AAMC. He has served as President of the Clerkship Directors in Internal Medicine (CDIM), and of the Alliance for Clinical Education (ACE), the coordinating council for eight national organizations of American clerkship directors. Dr. Pangaro has been honored by the AAMC with the Glaser Distinguished Teacher Award (2005), by USU students with the Clements Awards for Excellence in Education (1990) and by the USU Faculty with the inaugural Carol Johns Teaching Medal (2001). He has been recognized by the NBME with its Edith J. Levittt Distinguished Service Award; by CDIM with all three of their awards: the inaugural award for Outstanding Program Development (1998, now named the Louis Pangaro Award), the Outstanding Educational Research Award (2000), and the Outstanding Service Award (2005); and by the British Embassy Players for his production of Shakespeare's Hamlet (1990). He was recognized by the Army chapter of the American College of Physicians with its inaugural Master Teacher Award (1997) and by the Washington, DC chapter of the College with its Sol Katz Teaching Award (2005) and its Laureate Award (2012). In 2010, Dr. Pangaro was named as a Master of the American College of Physicians (MACP), and in 2012, he received the Distinguished Medical Educator Award the Association of Program Directors in Internal Medicine. In 2018 he received the John P. Hubbard Award from the NBME for excellence in the field of evaluation in medicine.


The themes of my scholarly work are seen in these selected publications, including studies and essays.

Google scholar link: https://scholar.google.com/citations?user=J-AjoWsAAAAJ&hl=en

Conceptual Frameworks of Assessment
• Pangaro L, A New Vocabulary and Other Innovations for Improving Descriptive In-training
Evaluations, Academic Medicine, 74: 1203-1207, 1999.
• Pangaro LN, A Shared Professional Framework for Anatomy and Clinical Clerkships, Clinical Anatomy, 2006, 19: 419-428.
• Pangaro L, ten Cate O, AMEE Guide - Frameworks for Learner Assessment in Medicine Medical Teacher, 35, 524 – 537, (2013)
• Pangaro L, Investing in Descriptive Evaluation: a vision for the future of assessment. Medical Teacher. 22(5), 478 - 481, 2000.
• Rodriguez R, Pangaro L, "Mapping the ACGME competencies to the RIME Framework", Academic Medicine, 87 (12), 1781.
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Research on RIME and Evaluation Systems
- Meyer EG, Kelly WF, Hemmer PA, Pangaro LN, The RIME Model provides a context for Entrustable Professional Activities across Undergraduate Medical Education, , Acad Med , 2018;93:954.8;93:9548;.
• Hemmer P, Hawkins R, Jackson J, Pangaro L, Assessing How Well Three Evaluation Methods detect Deficiencies in Medical Students' Professionalism in Two Settings of an Internal Medicine Clerkship, Academic Medicine 75, 167 - 173, 2000.
• Gaglione MM, Moores L, Pangaro L, Hemmer PA Does Group Discussion of Student Clerkship Performance at an Education Committee Affect an Individual Committee Member’s Decisions? Academic Medicine 80:S55-S58, 2005.
• DeWitt DE, Carline D , Paauw DS , Pangaro L, A Pilot Study of a "RIME" framework-based Tool for Giving Feedback in a Multi-specialty Longitudinal Clerkship, Medical Education, 42: 1205 -1209, 2008.

Standardized Examinees and Simulation
• Pangaro LN, Worth-Dickstein H, Macmillan K, Shatzer J, Klass D, Performance of "Standardized Examinees" in a Standardized Patient Examination of Clinical Skills, Academic Medicine. 72: 1008 –
• Worth-Dickstein H, Pangaro L, MacMillan MK, Klass DJ, Shatzer JH Use of "Standardized Examinees" to Screen for Standardized-patient Bias in a Clinical Skills Examination, Teaching and Learning in Medicine, 17(1), 9 – 13, 2005.
• LaRochelle JS, Durning SJ, Pangaro LN, Artino AR, van der Vleuten C, Schuwirth, Impact of Increased Authenticity in Instructional Format on Preclerkship Students' Performance: A Two-Year, Prospective, Randomized Study, Acad Med. Oct;87(10):1341-7, 2012.

Assessment of Competence
• Pangaro LN, Holmboe, “Evaluation Forms and Formal Rating Scales”, Practical Guide to the Evaluation of Clinical Competence, ed Holmboe and Hawkins, Elsevier, 2008, p 24-41.
• Donato AA , Pangaro L , Smith C, Rencic J , Diaz Y , Mensinger J , Holmboe E, Evaluation of a Novel Assessment Tool for Observing Medical Residents, a Randomized Controlled Trial, Medical Education, 42: 1234-1242, 2008.
• Durning SJ, LaRochelle J, Pangaro L , Artino A Boulet J, vanr der Vleuten C, Hemmer P ,
• Does the Authenticity of Preclinical Teaching Format Affect Subsequent Clinical Clerkship Outcomes? A Prospective Randomized Crossover Trial, Teaching Learning in Med. ,(2):177-82, 2012
• Durning SJ, Artino AR Jr, Pangaro LN, van der Vleuten C, Schuwirth L. Perspective: redefining context in the clinical encounter: implications for research and training in medical education. Academic Medicine , 85(5):894-901, 2010

Curricular Reform, and educational systems
• PangaroL, The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education - Students’ Progress from Understanding to Action, J International Assoc of Medical Science EducatorsVolume 20-3 307 – 313, 2010
• Finnerty EP, Chauvin S, Bonaminio G, Andrews M, Carroll RG, Pangaro LN. Flexner revisited: the role and value of the basic sciences in medical education. Academic Medicine. 85(2):349-55. 2010
• Pangaro L, Bachicha J, Brodkey A, Chumley-Jones H, Fincher RM, Gelb D, Morgenstern B, Sachdeva A, Expectations of and for Clerkship Directors - A Collaborative Statement from the Alliance for Clinical Education, Teach Learn Med2003 15: 217-222.
• Pangaro LN, editor, Leadership and Success In Medical Education, American College of Physicians, series on Teaching Internal Medicine (J. Ende, general editor), 2010, ACP Press, Philadelphia, PA.
• Gimbel R, Pangaro LN, Barbour G, America’s “Undiscovered” Laboratory for Health Service Research, Medical Care, Med Care. 2010 Aug; 48(8):751-
• Pock A, Pangaro L, Gilliland W, , The "Pillars" of Curriculum Reform" (manuscript #ACADMED-D-13-01220R1, Academic Medicine, accepted for publication,/69.
• Pangaro L, [invited] Commentary: getting to the next phase in medical education-a role for the vice-chair for education Academic Medicine, 2012 Aug;87(8):999-1001.
Faculty Development
• Roop S, Pangaro L, Measuring the Impact of Clinical Teaching on Student Performance during a Third Year Medicine Clerkship, Amer J Med. 110 (3). 205-209, 2001. (accompanying editorial, by Irby and Papadakis, "Does Good Clinical Teaching Really make a Difference?")
• Guidebook For Clerkship Directors, co-editor, 3rd edition, Ruth-Marie Fincher general editor, Alliance for Clinical Education, 2005.
• Schuster B and Pangaro L, Understanding Systems of Education: What to Expect of, and for, Each Faculty Member, in Leadership Careers in Medical Education, ed Pangaro, American College of Physicians, 2010, pp 51-71.
• Pangaro LN, editor, Leadership and Success In Medical Education, American College of Physicians, series on Teaching Internal Medicine (J. Ende, general editor), 2010, ACP Press, Philadelphia, PA.
- Pock AR, Ottolini M, Pangaro LN, Gilliland WR.COL, Reamy BV.Col, Hemmer PA, StephensM, O'Brien A, and Laughlin L Academic Change Management: Leadership Lessons From Curricular Reform, Military Medicine 2015 180:4S, 158-160
- O'Malley PG, Pangaro LN. Research in Medical Education and Patient-Centered Outcomes: Shall Ever the Twain Meet? JAMA Intern Med. 2016 Feb 1;176(2):167-8.

Electronic medical record
• Stephens MB, Gimbel RW, Pangaro L, The RIME/EMR Scheme: An Educational Approach to Clinical Documentation in Electronic Medical Records, Academic Medicine, 86, (1):11-14, 2010
• Hanson JL, Stephens MB, Pangaro LN, Gimbel RW, Quality of Outpatient Clinical Notes: A Stakeholder- derived Definition with Implications for a Quality Rating Instrument: A Qualitative Study, BMC Health Services Research, Nov 19;12:407, 2012.
• Harry B. Burke, Albert Hoang, ,1 Dorothy Becher, , 1 Paul Fontelo, ,3 Fang Liu, 3 CAPT Mark Stephens, Louis N. Pangaro, Laura L. Sessums, Patrick O’Malley,, Nancy S. Baxi,Christopher W. Bunt,Maj. Vincent F. Capaldi, Julie M. Chen, Barbara A. Cooper, David
A. Djuric,Joshua A. Hodge, Shawn Kane, Charles Magee, Zizette R. Makary, Renee M. Mallory, Thomas Miller, Adam Saperstein, Jessica Servey, Ronald W. Gimbel, QNOTE: A validated instrument for evaluating the quality of clinical notes, J Amer. Informatics Assoc, J Am Med Inform Assoc 2014;0:1–7.

Academic Leadership
- Pangaro L, Leadership education for physicians – how it fits in their culture Perspectives on Medical Education, Jun;8(3):131-132.

Career Highlights: Positions, Projects, Deployements, Awards and Additional Publications

Pangaro L, The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education - Students’ Progress from Understanding to Action, J International Assoc of Medical Science Educators Volume 20-3 307 – 313, 2010

Pangaro LN. Two Cheers for Milestones. J Grad Med Educ. 2015 Mar;7(1):4-6

Pangaro L, Leadership education for physicians – how it fits in their culture Perspectives on Medical Education, 2019, Jun;8(3):131-132

Pangaro, L “Why Isn’t Diagnosis Deep enough?” Artiss Symposium, Getting Beyond the Diagnosis, Center for the Study of Traumatic Stress, 2016

Schuster B and Pangaro L, Understanding Systems of Education: What to Expect of, and for, Each Faculty Member, in Leadership Careers in Medical Education, ed Pangaro, American College of Physicians, 2010, pp 51-71

Pangaro LN, Durning SJ, Holmboe, “Evaluation Frameworks, Forms and Formal Rating Scales”, Practical Guide to the Evaluation of Clinical Competence, ed Holmboe and Hawkins, Elsevier, 2017, p 37-60

Hu, Phillips, Pangaro Physician Burnout: Evidence That Leadership Behaviors Make a Difference Corresponding Author: James Co-Authors: Phillips, Phei Wee, Pangaro, accepted Military Med

Pock AP, Durning SJ, Gilliland WR , Pangaro LN, Post-Carnegie II Curricular Reform: A North American Survey of Emerging Trends & Challenges, BMC Med Educ. 2019 Jul 12;19(1):260. doi: 10.1186/s12909-019-1680-1

Representative Bibliography

Pangaro L, Burman KD, Wartofsky L, Cahnmann HJ, Smallridge RD, 0'BrianJT, Wright FD, and Latham K: Radio immunoassay for 3, 5-diiododiyronine (3,5T2) and evidence for dependence on - conversion from T3, J Clin Endocnn Metab 50:1075,1980.

Pangaro LN, Worth-Dickstein H, Macmillan K, Shatzer J, Klass D, Performance of "Standardized Examinees" in a Standardized Patient Examination of Clinical Skills, Academic Medicine. 72: 1008 - 1011,1997.

Pangaro L, A New Vocabulary and Other Innovations for Improving Descriptive In-training Evaluations, Academic Medicine, 74: 1203-1207, 1999.

Noel GL, Herbers J, Caplow M, Cooper G, Pangaro L, Harvey J, How Well Do Internal Medicine Faculty Members Evaluate the Clinical Skills of Residents? Annals of Internal Medicine 117 (9), 756- 765, 1992.

Hemmer P, Pangaro L, Formal Evaluation Sessions as Case-Based Faculty Development During Clinical Clerkships, Academic Medicine (2000) Z5.(12):1216-1221.

Pangaro LN, Gibson K, Russell W, Lucas C, Marple R. A Prospective, Randomized Trial of a Six- week Ambulatory Internal Medicine Rotation, Academic Medicine, 70: 537-541, 1995.

Hemmer P, Hawkins R, Jackson J, Pangaro L, Assessing How Well Three Evaluation Methods detect Deficiencies in Medical Students' Professionalism in Two Settings of an Internal Medicine Clerkship, Academic Medicine 75, 167 - 173, 2000.

Durning S, Pangaro L, Denton GD, Hemmer P, Wimmer A, Grau T, Gaglione MA, Moores L, Inter-site Consistency as a Standard of Programmatic Evaluation in a Clerkship with multiple, Geographically Separated Sites, Academic Medicine, Oct; 78:S36-S38, 2003.

Pangaro LN, A Shared Professional Framework for Anatomy and Clinical Clerkships, Clinical Anatomy, 2006, 19: 419-428.

Pangaro L, ten Cate O, AMEE Guide - Frameworks for Learner Assessment in Medicine (Theories in Medical Education series), Medical Teacher, 35, 524 – 537, (2013)