|
Last Reviewed
March 27, 2025
First Published
April 25, 2022
|
|
Prior to the start of a clinical rotation or experience, faculty should discuss their expectations of learner performance with the learners. Topics to discuss should include goals and objectives/outcomes, teaching strategies, evaluation and feedback techniques, daily schedule, clinical duties, case presentations, writing notes, supervision hierarchy, modes of communication, and other pertinent policies.
One Minute Preceptor (OMP), also known as the 5 micro skills of teaching, is a 5-step case-presentation framework facilitated by faculty used to assess decision making skills. After the learner has given a brief summary of the patient’s case, the faculty asks the learner to make a commitment, e.g., what’s going on with this patient, what do you want to do. Once the learner has committed to a diagnosis or plan, the faculty asks the learner to provide evidence to support the decision. Then, based on the learner’s responses, the faculty provides a general teaching rule, reinforces what was done right, and corrects mistakes. (Neher, 2003)
SNAPPS is a learner-centered case-presentation framework that allows faculty to assess clinical reasoning skills. The learner follows the mnemonic to summarize the patient, narrow the differential, analyze the differential, probe the faculty, plan the management, and identify an issue for self-study. Faculty can visualize the learner’s clinical reasoning skills and identify gaps in performance. (Wolpaw, 2003)
Prediction-Exposure-Feedback (Lang, 2021) is a learner centered framework used to engage students in the learning process while simultaneously seeing patients especially in the outpatient setting. Prior to seeing the patient, ask that student to predict. You might ask questions like what do you think is going on with this patient, what do you expect to find in the lab results or on the x-ray with this patient. Asking students to predict activates prior knowledge making it easier to make solid connections between new and previous knowledge. Seeing the patient acts as the exposure step. After seeing the patient, the student is asked to analyze their prediction; were they right or wrong. You can then correct any misconceptions and provide feedback on their prediction.
|
|
Use the comments section below to let us know your ideas about teaching in a clinical setting.
|
- When using the SNAPPS framework, learners made more differentials, exhibited more clinical reasoning skills for analyzing differentials, and raised uncertainties more often.
- Jain, V., Siddharth, R., & Jinadani, M. (2019). Effectiveness of SNAPPS improving clinical reasoning in postgraduates: Randomized controlled trial. BMC Medical Education, 19(224).
- Kapoor, A., Kapoor, A., Kalraiya, A., & Longia, S. (2017). Use of SNAPPS model for pediatric outpatient education. Indian Pediatric, 54, 288-290.
- Both the One Minute Preceptor and SNAPPS strategies have been found to improve clinical reasoning skills, “promote deeper discussion of clinical cases and a higher number of differential diagnoses”.
- Grunewald, S.T.F., Grunewald, T., Ezequiel, O.S., Lucchetti, A., & Lucchetti, G. (2022). One-minute preceptor and SNAPPS for clinical reasoning: A systematic review and meta-analysis. Internal Medicine Journal, 53, 680-689.
- Before setting expectations, take some time to think about and write down your expectations for learner performance.
- When using the OMP, give a teaching point that is easily generalizable to other patient cases.
- When using the SNAPPS framework, the faculty takes on a facilitator role and allows the learner to lead the case discussion.
|
