Effectiveness of the Implementation of SNAPPS in Family Medicine Residency Program in Erbil: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 36
- 试验地点
- 2
- 主要终点
- Total presentation length (Time in Minutes)
研究概览
简要总结
The goal of this Randomized Controlled Trial is to assess how well SNAPPS (Summarize history and findings; Narrow differentials; Analyze differentials; Probe preceptor about uncertainties; Plan management; Select case-related issues for self-study) facilitates clinical reasoning and enhances time management in an outpatient setting as a learner-centered method of case presentation when compared to the conventional method among family medicine board residents and tutors, the main objectives of the study are:
- To assess the implementation of a new technique of teaching and case presentation in family medicine residency program.
- To understand the perception of postgraduates and tutors about this new method of case presentation.
The researchers compared the outcomes of case presentations between two groups (the SNAPPS group and the control group) using dependable variables that has been used in previous researches to assess the SNAPPS versus the traditional method of case presentation.
Participants in the SNAPPS group were introduced to the SNAPPS method by a training session, while the control group needed no intervention.
Each student had to prepare and present two cases to the assigned tutor during their routine training days.
Data were collected by the tutors during each case presentation and the participants answered survey questions regarding their opinion of the case presentation.
详细描述
Clinical teaching's primary objectives include evaluating students' clinical reasoning abilities, advancing, and enhancing their development, as well as giving them clinical practice and feedback potential.
Whilst trying to assist postgraduate residents in improving their clinical reasoning, medical educators experience a variety of difficulties like uncooperative patients, record requirements, increasing tasks, time restraints, and productivity objectives that conflict with teaching time.
Students rarely convey their clinical reasoning or case-based doubts during traditional case presentations to preceptors, according to studies of such presentations. Instead, they tend to emphasize mostly on factual data However, the chance to consider one's own method of clinical thinking is seen as one of the most valuable components of the educational experience by both students and preceptors. Irby and Wilkerson have recently argued that there is a need for the development of time-effective teaching techniques in the clinical setting that give insights into the students' clinical reasoning strategies and doubts while also enabling the preceptor to stay completely involved in the priority areas of patient care.
Yonke and Foley questioned whether successful educational methods in the hospital setting would translate well to the office as medical education stepped from the inpatient to the outpatient setting.
Two models for enhancing clinical thinking ability-one-minute preceptor (OMP) and SNAPPS (Summarize history and findings; Narrow differentials; Analyze differentials; Probe preceptor about uncertainties; Plan management; Select case-related issues for self-study), have been well studied in the outpatient settings.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
Both the students (participants) and the preceptors (Outcome Assessors) in each group were unaware of the other group participants, Outcome Assessors, and the method used for case presentations.
We ensured that by asking the participants in both groups not to discuss any information regarding the study with anyone.
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Postgraduate students.
- •Pursuing the board degree in Family Medicine after completion of their M.B.Ch.B and internship.
- •(16 residents from the Arabic Board of Health Specialties fellowship and 14 residents from Kurdistan Board of Medical Specialties).
- •Tutors who worked at the department of Community and Family Medicine/ College of Medicine / Hawler Medical University.
- •Frequently instructed undergraduate and postgraduate students in the family medicine teaching health facilities.
- •(two assistant professors and four lecturers).
排除标准
- •Family Medicine residents, who are not enrolled in the Board study (not a postgraduate student)
结局指标
主要结局
Total presentation length (Time in Minutes)
时间窗: Data (Time) was recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The total case presentation time was measured in minutes. The comparison was made between the 2 groups' presentations depending on the mean of the total presentation time in each group.
Number of uncertainties expressed and obtained clarifications
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The comparison made depending on the mean number of uncertainties expressed and obtained clarifications in each group.
Number of justified diagnoses (Dx) in the differential diagnosis (DDx)
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The comparison made between the two groups on the mean number of justified diagnoses (Dx) in the differential diagnosis (DDx) in each group.
Duration of summary (Time in Minutes)
时间窗: Data (Time) was recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The duration of summary time was measured in minutes. The comparison was made between the 2 groups' presentations depending on the mean duration of summary in each group.
Number of basic clinical attributes covered
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The number of basic clinical attributes covered during each presentation was recorded and the comparison made between the two groups on the mean number of basic clinical attributed covered in each group.
Number of diagnoses kept (Dx) in differential diagnosis (DDx)
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The comparison made between the two groups on the mean number of diagnoses kept (Dx) in differential diagnosis (DDx) in each group.
Number of distinct comparisons made between two diseases
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The comparison made between the two groups on the mean number of distinct comparisons made between two diseases in each group.
Number of basic attributes in support of Diagnoses (Dx) in the differential diagnosis (DDx)
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The comparison made between the two groups on the mean number of basic attributes in support of Dx in the DDx in each group.
Did the student Discuss case related topics and resources?
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The answer was Yes or No. The comparison made between the two groups depending on the percentage of those who got (Yes) or (No) in each group.
Does the student seek clarification and information by asking questions and acknowledging their uncertainties?
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The answer was Yes or No. The comparison made between the two groups depending on the percentage of those who got (Yes) or (No) in each group.
Did the student discuss patient management plan?
时间窗: Data were recorded by the preceptors during each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.
The answer was Yes or No. The comparison made between the two groups depending on the percentage of those who got (Yes) or (No) in each group.
次要结局
- Preceptors' Feedback on each presentation(Data were recorded by the preceptors after each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.)
- Residents' Feedback on each presentation(Data were recorded by each resident after each case presentation, then analyzed using the Statistical Package for Social Sciences (SPSS, version 26) 2 weeks after all the presentations were finished.)
研究者
Ghaith Saad Abdulnafe Shindala
Dr
Ministry Of Health / Nineveh Health Directorate