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The underlying idea of this work is that medical students should learn to be effective problem solvers through their curricular experiences. The author studied 32 fourth year medical students from two colleges: 16 were from a college with a traditional curriculum; 16 were from a college whose curriculum included some early attempts at problem-oriented teaching. Students were randomly assigned to one of four treatment conditions. Four students from each college were provided with a set of heuristics for clinical problem solving and prompted to use them; four were provided with heuristics, but received no prompts for their use; four students from each college developed their own personal tests of problem solving heuristics and were prompted to use them; four developed their personal test but received no prompting. Subjects had initially worked through a paper case from which pretest measures were derived. Subjects who received the prepared set of heuristics were given aid in their use through another case. All subjects worked through two additional cases from which posttest measures were derived. The results indicate that fourth year medical students perform better on clinical cases when they have been given powerful heuristics. (Author/EB)