Shindala Ghaith S, Dauod Ali S, Alkhateeb Nazdar E
Ministry of Health, Ninevah Health Directorate, Mosul, IRQ.
Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, IRQ.
Cureus. 2024 Jul 19;16(7):e64897. doi: 10.7759/cureus.64897. eCollection 2024 Jul.
Background and objectives There is a crucial need to embrace modern methodologies for enhancing medical education in disciplines such as Family Medicine. The study introduces the SNAPPS (Summarize, Narrow, Analyze, Probe, Plan, and Select) model, a six-step mnemonic representing a learner-centered case presentation approach that streamlines fact reporting while encouraging clinical reasoning, aiming to evaluate the effectiveness of the SNAPPS method as compared to the traditional model of case presentation in Family Medicine outpatient clinics and to gain insights into how students and preceptors perceive it. Methods A randomized controlled trial was conducted in Family Medicine outpatient clinics in Erbil, Iraq, from March 15, 2023, to August 30, 2023. Using convenience sampling, all Family Medicine board residents (n=30) in Erbil and six preceptors from the Community and Family Medicine department/College of Medicine/Hawler Medical University were randomly assigned into two groups by using the RAND function in Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). The SNAPPS method was introduced to the SNAPPS group employing approved tools and methods, while no intervention was needed in the control group. Subsequently, 30 cases were presented in each group with a total of 60 case presentations; the case presentations served as the units for data analysis. Feedback and data were gathered after each presentation using validated data recording sheets. Results The study showed a significant advantage for the SNAPPS group over the control group in terms of time efficiency, number of basic clinical attributes covered, and justified diagnoses (P value < 0.001). In the SNAPPS group, 90% of the students sought clarification and information, surpassing 30% in the control group (P-value < 0.001). Almost all SNAPPS group students (96.7%) discussed case-related topics, compared to 43.3% in the controls (P-value<0.001). The SNAPPS group received superior overall ratings from both preceptors and students. Conclusion The SNAPPS method enhances clinical diagnostic reasoning in Family Medicine outpatient clinics. It is time-efficient and encourages students to articulate uncertainties, pose questions, and identify case-related topics for self-study.
背景与目标 迫切需要采用现代方法来加强家庭医学等学科的医学教育。本研究引入了SNAPPS（总结、缩小范围、分析、探究、计划和选择）模型，这是一种六步记忆法，代表了以学习者为中心的病例汇报方法，在简化事实报告的同时鼓励临床推理，旨在评估SNAPPS方法与家庭医学门诊传统病例汇报模型相比的有效性，并深入了解学生和带教老师对它的看法。方法 2023年3月15日至2023年8月30日在伊拉克埃尔比勒的家庭医学门诊进行了一项随机对照试验。采用便利抽样法，使用微软Excel（微软公司，美国华盛顿州雷德蒙德）中的随机函数将埃尔比勒所有家庭医学委员会住院医师（n = 30）和来自社区与家庭医学系/医学院/霍勒医科大学的六名带教老师随机分为两组。采用经批准的工具和方法向SNAPPS组介绍SNAPPS方法，而对照组无需干预。随后，每组展示30个病例，共60个病例汇报；病例汇报作为数据分析的单位。每次汇报后，使用经过验证的数据记录表收集反馈和数据。结果 研究表明，SNAPPS组在时间效率、涵盖的基本临床特征数量和合理诊断方面比对照组具有显著优势（P值<0.001）。在SNAPPS组中，90%的学生寻求澄清和信息，超过对照组的30%（P值<0.001）。几乎所有SNAPPS组的学生（96.7%）都讨论了与病例相关的话题，而对照组为43.3%（P值<0.001）。SNAPPS组从带教老师和学生那里都获得了更高的总体评分。结论 SNAPPS方法可增强家庭医学门诊的临床诊断推理能力。它节省时间，并鼓励学生阐明不确定性、提出问题以及确定与病例相关的自学主题。
