Abstract
IntroductionOne-minute preceptor (OMP) and SNAPPS (a mnemonic for Summarize history and findings; Narrow the differential; Analyze the differential; Probe the preceptor about uncertainties; Plan management; and Select case-related issues for self-study) are educational techniques developed to promote learners’ expression of clinical reasoning during the case presentation in the workplace. The aim of this present study was to compare the content of the case presentation between the SNAPPS and the OMP methods.MethodsThis was a randomized controlled trial comparing SNAPPS and OMP in 60 medical students at the beginning of their fifth year of medical school. After an introduction session, students presented and discussed two cases based on real patients and provided in written format. All case presentations were recorded and evaluated by two researchers. The assessed elements of the case presentations were divided into three subgroups related to expression of clinical reasoning, time and initiative to guide the presentation.ResultsThere were 30 participants in each group. There was no difference in the expression of clinical reasoning between OMP and SNAPPS groups (number of differential diagnoses, justification of most likely diagnosis and differential diagnosis, expression of comparing and contrasting hypotheses). However, students in the SNAPPS group expressed significantly more questions and uncertainties (p < 0.001), and more often took the initiative to present and justify the most likely diagnosis, differential diagnosis and management plan than students in the OMP group, both in simple and complex cases (all p values <0.001) without extending the length of the teaching session.ConclusionOMP and SNAPPS equally promote medical students’ expression of clinical reasoning. The SNAPPS technique was more effective than the OMP technique in helping students to take on an active role during case presentation. We propose SNAPPS as an effective learning tool, engaging students and promoting the expression of their clinical reasoning as part of a case presentation.
Highlights
One-minute preceptor (OMP) and SNAPPS are educational techniques developed to promote learners’ expression of clinical reasoning during the case presentation in the workplace
It is a core competence of medical practice, which medical students and junior doctors need to learn under the supervision of clinical teachers
Tab. 1 shows the results for each outcome with the simple and complex case in the SNAPPS and OMP groups
Summary
One-minute preceptor (OMP) and SNAPPS (a mnemonic for Summarize history and findings; Narrow the differential; Analyze the differential; Probe the preceptor about uncertainties; Plan management; and Select case-related issues for selfstudy) are educational techniques developed to promote learners’ expression of clinical reasoning during the case presentation in the workplace. The oral case presentation (‘tell me about the patient you just saw in clinic’) is the most commonly used tool allowing clinical teachers to evaluate and activate the learner’s clinical reasoning [2] In such oral case presentations medical students and inexperienced junior doctors focus mainly on factual information and seldom express spontaneously their thoughts and reasoning, making assessment difficult [3, 4]. The lack of sufficient evidence about teaching methods in the clinical setting is a critical gap in the literature
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