Use of a "scheme" approach to problem solving during a family medicine clerkship

Previous research reported significant improvement in performance when students used a "scheme" rather than a "search & scan" approach to problem solving. To supplement the limited research in this area, a pilot study was conducted to determine whether students who are provided problem solving schemes demonstrate use of a scheme approach when problem solving and whether they perform differently oil a measure of diagnostic thinking fi-om students who are not provided schemes. Students in four consecutive family medicine rotations participated in the study. Students in two rotations were introduced to problem solving schemes during the clerkship orientation and encouraged to use the schemes throughout the rotation when attempting to diagnose clinical problems. Students in the other two rotations were not provided problem solving schemes. Students who were provided schemes showed evidence of scheme utilization on the written exam, However, differences between the two groups in diagnostic thinking were observable but not statistically significant. Students who were provided schemes reported minimal use of the schemes during the rotation. The findings and recommendations are discussed within the context of the "scheme" and "search & scan" strategies.