Accelerated learning at masters’ level: problem based learning of diagnostic reasoning skills by physician associate students

Physician Associates (PA) complete a two year postgraduate course, and are expected to graduate with diagnostic skills equivalent to those of newly qualified doctors who have completed a five year course. BSMS has utilised Problem Based Learning (PBL) in an attempt to accelerate the acquisition of these skills by PAs. Weekly PBL sessions were conducted during year 1 of the PA course, focusing on the ‘top 20’ core conditions within the curriculum. Alongside this, students had weekly clinical exposure in General practice. In order to assess the impact of this strategy the ‘Diagnostic Thinking Inventory‘ (DTI) developed by Bordage et al. (1990) was conducted three times across year 1 and the results compared to standardised data for medical students and doctors. This found that PA students had a significantly higher baseline score in terms of flexibility of thinking (equivalent to newly qualified doctors engaged in foundation training) and structure of memory (equivalent to third year medical students). Results showed a statistically significant improvement in structure of memory across year 1: achieving an improvement in score which took over four years to achieve in medical students. This appears to suggest that PBL can facilitate increased assimilation of diagnostic reasoning skills within postgraduate learners. Keywords: Physician Associate, Diagnostic Reasoning, Problem Based Learning, Postgraduate.