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Student uncertainties drive teaching during case presentations: more so with SNAPPS.
Acad Med. 2012 Sep; 87(9):1210-7.AM

Abstract

PURPOSE

To compare the nature of uncertainties expressed by medical students using the six-step SNAPPS technique for case presentations (Summarize history and findings; N>arrow the differential; Analyze the differential; Probe preceptors about uncertainties; Plan management; Select case-related issues for self-study) versus those expressed by students doing customary presentations and to elucidate how preceptors respond.

METHOD

The authors performed a secondary analysis in 2009 of data from a 2004-2005 randomized study, comparing SNAPPS users' case presentations with other students' presentations. Authors coded transcriptions of audiotaped presentations to family medicine preceptors for type of student uncertainties, nature of preceptor responses, alignment of preceptor responses with uncertainty types, and expansion of preceptors' responses beyond addressing uncertainties.

RESULTS

The analysis included 19 SNAPPS and 41 comparison presentations. SNAPPS students expressed uncertainties in all case presentations, nearly twice as many as the comparison group (χ1df = 12.89, P = .0001). Most SNAPPS users' uncertainties (24/44 [55%]) focused on diagnostic reasoning compared with 9/38 (24%) for comparison students' (χ1df = 8.08, P = .004). Uncertainties about clinical findings and medications/management did not differ significantly between groups. Preceptors responded with teaching aligned with the uncertainties and expanded 24/66 (36%) of their comments.

CONCLUSION

Students can drive the content of the teaching they receive based on uncertainties they express to preceptors during case presentations. Preceptors are ready to teach at "the drop of a question" and align their teaching with the content of students' questions; these learning moments-in context and just-in-time-can be created by students.

Authors+Show Affiliations

Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-4924, USA. Terry.wolpaw@case.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22836851

Citation

Wolpaw, Terry, et al. "Student Uncertainties Drive Teaching During Case Presentations: More so With SNAPPS." Academic Medicine : Journal of the Association of American Medical Colleges, vol. 87, no. 9, 2012, pp. 1210-7.
Wolpaw T, Côté L, Papp KK, et al. Student uncertainties drive teaching during case presentations: more so with SNAPPS. Acad Med. 2012;87(9):1210-7.
Wolpaw, T., Côté, L., Papp, K. K., & Bordage, G. (2012). Student uncertainties drive teaching during case presentations: more so with SNAPPS. Academic Medicine : Journal of the Association of American Medical Colleges, 87(9), 1210-7.
Wolpaw T, et al. Student Uncertainties Drive Teaching During Case Presentations: More so With SNAPPS. Acad Med. 2012;87(9):1210-7. PubMed PMID: 22836851.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Student uncertainties drive teaching during case presentations: more so with SNAPPS. AU - Wolpaw,Terry, AU - Côté,Luc, AU - Papp,Klara K, AU - Bordage,Georges, PY - 2012/7/28/entrez PY - 2012/7/28/pubmed PY - 2012/12/10/medline SP - 1210 EP - 7 JF - Academic medicine : journal of the Association of American Medical Colleges JO - Acad Med VL - 87 IS - 9 N2 - PURPOSE: To compare the nature of uncertainties expressed by medical students using the six-step SNAPPS technique for case presentations (Summarize history and findings; N>arrow the differential; Analyze the differential; Probe preceptors about uncertainties; Plan management; Select case-related issues for self-study) versus those expressed by students doing customary presentations and to elucidate how preceptors respond. METHOD: The authors performed a secondary analysis in 2009 of data from a 2004-2005 randomized study, comparing SNAPPS users' case presentations with other students' presentations. Authors coded transcriptions of audiotaped presentations to family medicine preceptors for type of student uncertainties, nature of preceptor responses, alignment of preceptor responses with uncertainty types, and expansion of preceptors' responses beyond addressing uncertainties. RESULTS: The analysis included 19 SNAPPS and 41 comparison presentations. SNAPPS students expressed uncertainties in all case presentations, nearly twice as many as the comparison group (χ1df = 12.89, P = .0001). Most SNAPPS users' uncertainties (24/44 [55%]) focused on diagnostic reasoning compared with 9/38 (24%) for comparison students' (χ1df = 8.08, P = .004). Uncertainties about clinical findings and medications/management did not differ significantly between groups. Preceptors responded with teaching aligned with the uncertainties and expanded 24/66 (36%) of their comments. CONCLUSION: Students can drive the content of the teaching they receive based on uncertainties they express to preceptors during case presentations. Preceptors are ready to teach at "the drop of a question" and align their teaching with the content of students' questions; these learning moments-in context and just-in-time-can be created by students. SN - 1938-808X UR - https://www.unboundmedicine.com/medline/citation/22836851/Student_uncertainties_drive_teaching_during_case_presentations:_more_so_with_SNAPPS_ L2 - https://doi.org/10.1097/ACM.0b013e3182628fa4 DB - PRIME DP - Unbound Medicine ER -