August 4, 2021
Apr 10, 2015
By Christopher Forest, MS, PA-C, DFAAPA
Director of research and an assistant professor of clinical family medicine at USC
The Challenge Bowl competition is reliably one of the highlights of the AAPA conferences, bringing in hundreds of attendees for this event and including over 70 PA programs from across the nation. In light of the competitive nature among the students, one of the challenges is to continue to view this as a game, a place where accumulated knowledge and serious preparation meets the luck of knowing a random piece of medical knowledge.
There are as many ways of preparing for this event as there are PA programs, however, I’d like to share the approach we’ve used at the University of Southern California (USC) for the last 6 years. These are our operating principles:
Open Practices: Practices are open to the entire student body. Any student who wants to participate may do so at any time. We will often have 20 students attending who have no interest in actually competing on stage, but do so because they feel it will prepare them for their upcoming didactic courses or their PANCE exams. After all, it never hurts to learn as much as you can.
Building Team Attitudes: Just being students together in a room is not enough to build a team. Having students bring food to share and eating together builds unity. Icebreaker exercises, such as asking everyone to share stories about themselves in small groups, can increase their trust in each other and help feel connected.
Rule 1: No Guilt. Attendance is completely voluntary and we stand by that. Students should not feel guilty about missing practices, not doing assignments, showing up unprepared, or choosing to go to a family event instead of practice. This is an approach that might frustrate a lot of coaches but it works when students have a strong motivation to be part of the team and to compete. Drawing them in with free pizza at the beginning of practices every now and then also helps. There’s an old saying: “Feed them and they will come.”
Rule 2: Proportional Yield. What students receive from participation is directly proportional to the effort they put into it. This is explained early in the process. Once they get in the habit of developing lists for each subject, the process becomes easier, they begin to notice themselves doing better in their classes, and they feel more confident about being prepared for Boards. The excitement for learning then builds.
Developing Lists: Memorizing lists of pathognomonic terms and triads is a good place to start but limits their ability to respond to questions about mechanism of action or involving clinical reasoning. Preparing well is not about memorizing lists as much as it is learning the material. We don’t provide lists for our students – they develop them. One exercise we use is to divide them into groups of 3-4 students, instruct them to review a chapter, extract the important information, and then explain it to the others in their group so that everyone understands. We encourage topics to coincide with what they’re learning in class.
Speed Drills: When it comes to competing in the Challenge Bowl, it doesn’t matter how much students know, but how fast they can recall that information. As part of the practice time, we split students into teams of three for mock competitions using makeshift buzzers. After three correct answers, the team that wins stays in front of the class, while the other team is replaced. Students become addicted to the competition and study even harder to try to win these mock challenges. Who says learning can’t be fun?
Assignments: Students are each assigned a different topic of medicine each week to prepare to teach each other the following week. There is no expectation as to the amount of information they need to prepare. As much as they can do is welcomed.
Reflection: An important part of the process of teambuilding is to set aside time at the end of practices to reflect on the process. What worked well and what didn’t? What types of exercises or assignments helped the students the most? This reflective process gives the students a sense of ownership, where they become invested in the process.
Selecting who participates on stage: In our experience, by a week or two before the event, the students who have participated the most in practices and are enjoying the speed drills the most, self-select to compete on stage. These students have a breadth of medical knowledge in combination with quick recall.
Pre-competition briefing: We remind students that although they play to win, in the end, it is meant to be fun. They should enjoy themselves. Anxiety is normal as well as the desire to not let anyone down, but they need to be reminded that all they can do is to do their best. After all, it is a game. It’s meant to be fun and if they don’t win, it’s important that they behave professionally and graciously.
Post-competition debriefing: It has been helpful for us to meet after the competition in a quiet location as a team, or more as a family by now, to vent, talk about our feelings and encourage each other. After that, we celebrate.
Win or lose, it’s a huge accomplishment and the experience is one that enriches each of the students, academically, professionally, and personally. And it’s all disguised as fun!