PDF(Pubmed)
Abstract：
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.
摘要：
背景和目标迫切需要采用现代方法来增强诸如家庭医学之类的学科的医学教育。该研究介绍了SNAPPS(Summarize，狭窄,分析,探头,计划,和选择)模型，六步助记符表示以学习者为中心的案例介绍方法，简化了事实报告，同时鼓励临床推理，旨在评估SNAPPS方法与家庭医学门诊的传统病例介绍模型相比的有效性，并深入了解学生和受体如何看待它。方法在埃尔比勒家庭医学门诊进行随机对照试验。伊拉克,从2023年3月15日到2023年8月30日。使用方便采样，Erbil的所有家庭医学委员会居民（n=30）和来自社区和家庭医学系/医学院/霍勒医科大学的六个受体被随机分为两组，使用MicrosoftExcel中的RAND函数（MicrosoftCorporation，雷德蒙德,华盛顿,美国)。SNAPPS方法被引入SNAPPS小组，使用批准的工具和方法，而对照组不需要干预。随后，每组30例，共60例，以病例为单位进行数据分析。每次演示后，使用经过验证的数据记录表收集反馈和数据。结果SNAPPS组在时间效率上明显优于对照组,涵盖的基本临床属性数量，和合理的诊断（P值<0.001）。在SNAPPS组中，90%的学生寻求澄清和信息，对照组超过30%(P值<0.001)。几乎所有SNAPPS组学生(96.7%)都讨论了与案例相关的话题,与对照组的43.3%相比（P值<0.001）。SNAPPS组获得了来自导师和学生的优异总体评分。结论SNAPPS方法增强了家庭医学门诊的临床诊断推理。它具有时效性，并鼓励学生表达不确定性，提出问题，并确定与案例相关的主题进行自学。
