Clinical training is one of the most critical phases of physician assistant education, requiring students to apply classroom knowledge in real patient care settings. At Harding University, Nicole Mount, PA-C and Clinical Director of the university’s physician assistant program, is responsible for overseeing student assignments during clinical rotations and ensuring learners are prepared for their end-of-rotation exams and the PANCE.
In this testimonial, Mount discusses how interactive case-based learning and AI-powered clinical simulations are helping support students during their rotations while also reducing faculty workload and providing consistent, real-time feedback.
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My name is Nicole Mount. I am a physician assistant and currently serve as the Clinical Director for the Harding University PA program.
As the clinical director, I give assignments to students while they are out on rotation. I ask for feedback about those assignments and about any other resources they may be utilizing during the clinical phase.
I actually had a student bring Sketchy to me and I was intrigued. I reached out and learned that they had a new product called DDx that they were implementing.
It sounded interesting and promising — something that we could utilize as a required assignment throughout rotations.
The way our program is set up, students are completing their required rotations but not necessarily in the same order. Having a bank of cases that speaks to their end-of-rotation exams and what they’ll eventually see on the PANCE is really helpful.
I can set that expectation at the beginning and know that no matter when students complete their family medicine rotation, they will receive the same exposure.
A really nice feature in DDx is that you can choose whether a case is designed for the clinical phase or the didactic phase.
You can also look for specific features like whether the case is heavy on critical thinking or specifically focused on history and physical.
What I tried to do is assign cases in earlier weeks that focus more on history and physical — the baseline skills we expect.
Then for later weeks in the rotation assignments, I would choose cases that are heavier on clinical application and critical thinking.
Previously I was using a product that had cases with questions that I had to create myself. I had to write the questions, manually grade them, and then give students feedback on their answers.
I also wanted to make sure that Student A’s feedback matched Student B’s feedback. It was a lot to manage for 36 students every week on top of everything else.
I really appreciate DDx because I trust that students are getting good feedback, that it’s consistent, and that it matches what we’ve taught them. That’s been a huge help for me personally.
Creating the courses was really easy. Assigning them to students has been really easy. It’s also customizable for faculty — you can pick and choose cases and elements of the case that you want to highlight.
It’s also helpful when trying to identify gaps in our curriculum or areas where we want to provide more instruction.
An example of that was our neurology section. DDx gave us a way to find cases that specifically addressed areas where we wanted to strengthen learning.
I’m always looking for ways to make assignments clinically relevant and engaging. Giving students a product that utilizes AI and provides real-time feedback instead of static assignments has worked well for these learners.
It’s a different generation of learner than when I went through school. Having a tool that they’re familiar with and that feels relevant really helps with student buy-in.
I assign weekly cases for students to complete, and so far the feedback has been really positive.
Students really like the interactive features. They like that they can ask questions and get answers in real time. They like working at their own pace.
They also like the hints.
Students are not shy about complaining when they don’t like something, so the fact that I not only don’t hear complaints but have students asking for more cases speaks highly of the product.
We started using DDx in August of 2025 with our class of 2026 cohort.
During the clinical phase, students complete seven required rotations: family medicine, surgery, emergency medicine, internal medicine, mental and behavioral health, pediatrics, and women’s health. They also have the option to complete two elective rotations.
DDx has been a really nice way to assess clinical reasoning and ensure students are working through cases relevant to the rotations they’re experiencing.
These cases also address topics they’ll be assessed on during their end-of-rotation exams and eventually on the PANCE.
In academics, we wear a lot of hats. I’m functioning as the clinical director, but I’m also teaching faculty and helping with labs. I’m juggling many responsibilities.
Because DDx gives students real-time feedback in a standardized way, it removes a lot of the back-and-forth that used to happen between me and the student when trying to assess their clinical reasoning.
Previously that process was very time-consuming and not always standardized.
We typically have between 65 and 72 students in the clinical phase. That means over 150 rotation placements in a semester and hundreds of weekly assignments to manage.
DDx has really helped with clinical application and preparing students for their assessments.
Another problem I’m hoping to solve with DDx is when students fall short of required clinical hours or patient encounters during rotations.
Being able to assign cases as an alternative learning experience is something I’m planning to implement instead of trying to find additional clinical placements.
Overall, DDx helps balance workload and gives students meaningful opportunities to practice clinical reasoning.
