The Interactive Learning System: My Most Successful Student Study Strategy

In our previous blog, Basic Study Skills: Our Responsibility or the Students’?, we introduced the topic of whether teaching basic study skills is our responsibility as faculty in professional programs.


Personally, taking on this responsibility has been a natural extension of my (Scott) role as a PA educator. In fact, by embracing this duty, I developed a study skill many years ago over hundreds of hours of tutoring and interaction with students. It quickly proved itself to be highly successful among PA students. If you’re an educator struggling to help students who seem unable to assimilate the vast amount of information presented in professional programs, this is a skill you’ll want to know about.


As a PA educator in the 90’s, predicting how students would perform on certification exams after graduation seemed impossible. Through interviews with students who failed their certification exam on the first attempt, I found they each lacked a study system. They often viewed the information as something to be memorized rather than assimilated; when this didn’t work, though, they didn’t know how to improve their learning process through trial and error. The students eked through by barely passing the entire program. Unfortunately, without any predictors like the modern PACKRAT, they went on to fail the exam.


I began experimenting a new method, asking students to approach their study material through a systematic means of connecting it into a logical framework. I instructed them to handwrite each of the disease items on the NCCPA website using the following overarching concepts:


1. Definition

2. Etiology/Pathogenesis

3. Pertinent Historical Findings/Clinical Symptoms

4. Pertinent Physical Exam Findings

5. Differential Diagnosis

6. Diagnostic Evaluations

7. Medical Management

8. Surgical Management

9. Emergency Management

10. Patient Education/Maintenance–Prevention


This required a large but necessary amount of work since many of the students didn’t know how to scaffold information or understand how the pieces connected. Bloom’s Taxonomy played an enormous role in this process. Rote memorization was inadequate.



For twelve years, I tutored more than 75 graduates who initially failed the PANCE. When students followed this approach exactly, the success rate was nearly 100%. There were remarkable transformations in the students’ performances: many of them raised their scores more than 100 points on the second attempt.


Seeing the success of this approach, I soon used it with my first-year PA students, incorporating it as a required assignment in clinical medicine. At the time, I was the principal clinical medicine instructor, so I experimented with integrating this as a fundamental part of the process, coining the term “Interactive Learning System” (ILS).


During my PhD studies in the late 90’s, I came across a quote by Sir William Osler that crystallized these concepts even further:


“Ask any active businessman or a leader in a profession the secret which enables him to accomplish much work, and he will reply in one word: system; or as I shall term it, the Virtue of Method… Thus, faithfully followed day by day, system may become at last ingrained in the most shiftless nature, and at the end of the semester a youth of moderate ability may find himself far in advance of the student who works spasmodically and trusts to cramming.”


By 2006, I launched the first systematized study process to find whether this study method could be replicated at the program level and demonstrate results on a more macrolevel. I collaborated with Dr. Mona Sedrak, the former program director at Seton Hall University. We previously worked together at Kettering College PA program, where my ILS was first developed. I also collaborated with Dr. Louise Lee, the current program director at St. John’s University, which led to the publishment of my first academic article, The Effects of an Interactive Learning System on PANCE Performance.

At the same time these collaborations were occurring, I was incorporating the use of predictive scores based on formative and summative exams. This successfully identified students who required more intensive tutorials. Students used the ILS to study for clerkship exams and the PANCE during the clinical year. When both methods were fully incorporated, the first-time taker pass rate never dipped below 95%.


Between 2007- 2010, Dr. Mona Sedrak and I worked with FA Davis to publish the conceptual framework of the interactive learning system in a book for PA students. Dr. Sedrak and I recruited dozens of test writers and authors of high-impact outlines to join us in writing every chapter. We published Classroom to Clinic Study System in 2011. The construction of this book included a robust student study skill component; since then, I’ve never stopped incorporating a 10-hour seminar series for students in the first 2-4 weeks of the program.


Dozens of PA programs used the Classroom to Clinic Study System in the early 2010’s. Students were required to complete the assignments within the CD system in the book, which involved constructing the outline within the system, then comparing it to the prototypical outlines within the CD. The ILS method was not widely embraced by PA students due to the large amount of construction of information required. Students didn’t want to construct outlines; they wanted to study the information using more efficient study manuals. As a result, programs discounted the value of this study method.


Despite this, I continue to use this method because it has a continued success rate among students grappling with the vast amount of information.


Recently, I worked with a second-year student who failed her first two EORE. After discussing her study methodology, it was evident she needed to construct the information. (See a copy of the exact outline here.) I instructed her to take the topics from the PAEA EORE blueprints and construct outlines in the same fashion. Her grade raised from 66% to 81%.


This methodology can work for any student; its success has been proven again and again for almost three decades. If you’d like to learn more about the Interactive Learning System, don’t hesitate to reach out to us. We offer helpful workshops to provide a tutorial for your faculty on incorporating the ILS for your students.


It’s rare for a student not to succeed when they are equipped with the tools to further develop their metacognitive skills. Of all the achievements during my academic career, developing this study method has been the most gratifying.