BACKGROUND To apply what has been learned theoretically in a clinical context is for many students a major challenge. In order to ease their transition into practice, a training programme was developed, focusing on learning to solve clinical problems. AIMS The programme is designed for veterinary medicine students in the preclinical phase with already a sound theoretical base in biomedical and clinical sciences. The design is based on the engagement in learning and work processes derived from clinical practice and exposure to a large variety of real and paper-based cases. This article addresses the effectiveness of this programme design. METHOD Programme effectiveness was defined in terms of the progress made by the students. This progress was established using methodological triangulation of the results from student questionnaires, performance observations and (pre and post) assessment. RESULTS On all dimensions of effectiveness, the results consistently showed that the programme was perceived as effective and led to improved performances in solving clinical problems and better solutions in the assessment. The students' progress was substantial. CONCLUSIONS At preclinical level, a course design based on the work processes in clinical practice and a mixture of real and paper-based patients is effective in enhancing problem-solving competence.