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Medical EducationNCT06484010

Effectiveness of SNAPPS in Family Medicine Residency Program

A study testing SNAPPS Model of case presentation in people with Medical Education, run by Hawler Medical University at 1 site in Iraq.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

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… Read more about this study

Who is it for?
Any age
Conditions the study is for
Medical Education
What is being tested?
SNAPPS Model of case presentation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
1 siteIraq
Study dates
15 Mar 2023to 30 Aug 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Residents:
  • 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).
  • Preceptors
  • 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).

Who cannot join

  • Family Medicine residents, who are not enrolled in the Board study (not a postgraduate student)

Trial locations and contacts

1 site in 1 country.

Iraq1 site
  • Hawler Medical University/ College of Medicine

    Erbil, 44001

Other trials in Iraq

About this study

Official title: Effectiveness of the Implementation of SNAPPS in Family Medicine Residency Program in Erbil: A Randomized Controlled Trial

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.
Read more

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.

Read the detailed description

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.

Additionally, by using these teaching models, preceptors can give trainees a more specific education without losing more precious time.

In the SNAPPS paradigm, the student presents a case to the preceptor by giving an informative summary of the pertinent information, which is followed by five steps that advocate for the expression of thinking and reasoning aloud. These actions are inspired in part by the rating scales for cognitive activity created by Connell et al.

The SNAPPS paradigm relies on a learner-teacher continuum which in the end, should be led by the learner, but may initially require coaching from the preceptor to assist the learner become comfortable and proficient with the processes. It is now both the trainer's and trainee's responsibility to ensure the prosperity of the learning process rather than just one of them.

To improve medical education in Family Medicine and other fields as well, we must comprehend and keep up with contemporary methodologies as they evolve in education.

The Aim of the study is to assess how well SNAPPS facilitates clinical reasoning and enhances time management in an outpatient setting when compared to conventional method of case presentation.

Being tested
SNAPPS Model of case presentation
Keywords
Medical education, SNAPPS, Clinical reasoning, Iraq

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SNAPPS Model of case presentationOther

    The intervention was the implementation of the SNAPPS model as a method of case presentation in out-patient settings.

    All preceptors and residents in the SNAPPS group were sensitized and trained one week before the beginning of case presentations and data collection by a training session that was carried out by the authors at Brayati Primary Health Center training hall for a duration of more than two hours, the session included a preview of the traditional method, introduction to the SNAPPS method, role play and doubts clarification.

    The training materials included a presentation explaining the SNAPPS method in details with examples, instructional videos, and handouts highlighting the six steps of the SNAPPS method.

    Before the beginning of the presentation by 72 hours, there was a double check by the principal investigator with all participants regarding the method and all doubts were clarified.

Study groups in NCT06484010
Study groupRoleWhat they receive
SNAPPS GroupActive comparatorThe intervention was the implementation of the SNAPPS model as a method of case presentation in out-patient settings.
Receives: Other: SNAPPS Model of case presentation
Control GroupNo interventionIn the control group, as both learners and preceptors are familiar with the traditional method of case presentation, no special training was required.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Total presentation length (Time in Minutes)

    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.

    Measured: 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.

  2. Duration of summary (Time in Minutes)

    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.

    Measured: 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.

  3. Number of basic clinical attributes covered

    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.

    Measured: 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.

  4. Number of diagnoses kept (Dx) in differential diagnosis (DDx)

    The comparison made between the two groups on the mean number of diagnoses kept (Dx) in differential diagnosis (DDx) in each group.

    Measured: 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.

  5. Number of basic attributes in support of Diagnoses (Dx) in the differential diagnosis (DDx)

    The comparison made between the two groups on the mean number of basic attributes in support of Dx in the DDx in each group.

    Measured: 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.

  6. Number of justified diagnoses (Dx) in the differential diagnosis (DDx)

    The comparison made between the two groups on the mean number of justified diagnoses (Dx) in the differential diagnosis (DDx) in each group.

    Measured: 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.

  7. Number of distinct comparisons made between two diseases

    The comparison made between the two groups on the mean number of distinct comparisons made between two diseases in each group.

    Measured: 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.

  8. Does the student seek clarification and information by asking questions and acknowledging their uncertainties?

    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.

    Measured: 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.

  9. Number of uncertainties expressed and obtained clarifications

    The comparison made depending on the mean number of uncertainties expressed and obtained clarifications in each group.

    Measured: 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.

  10. Did the student discuss patient management plan?

    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.

    Measured: 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.

  11. Did the student Discuss case related topics and resources?

    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.

    Measured: 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.

Secondary outcomes (2)
  1. Residents' Feedback on each presentation

    Measures the residents' agreement on Likert Scale-based questionnaire (a scale used to represent people's attitudes, opinion or perception to a topic) regarding their experience in each case presentation, the format of the scale was composed of 5 level Likert items (5 indicating strongly agree whereas 1 indicating strongly disagree)

    1. Strongly disagree (minimum)
    2. Disagree
    3. Neither agree nor disagree (neutral)
    4. Agree
    5. Strongly agree (maximum)

    The Feedback of the residents in both groups was compared to each other depending on the mean of their scores.

    Measured: 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.

  2. Preceptors' Feedback on each presentation

    Measures the preceptors' agreement on Likert Scale-based questionnaire (a scale used to represent people's attitudes, opinion or perception to a topic) regarding their experience in each case presentation, the format of the scale was composed of 5 level Likert items (5 indicating strongly agree whereas 1 indicating strongly disagree)

    1. Strongly disagree (minimum)
    2. Disagree
    3. Neither agree nor disagree (neutral)
    4. Agree
    5. Strongly agree (maximum)

    The Feedback of the preceptors in both groups was compared to each other depending on the mean of their scores.

    Measured: 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.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jul 2024
  2. Study start15 Mar 2023
  3. Primary completion30 Aug 2023
  4. Study completion30 Aug 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Thirty Family Medicine board residents and six preceptors from the department of Community and Family Medicine/ College of Medicine/ Hawler Medical University, were chosen by the convenience method and randomly distributed into two groups; the intervention group with the SNAPPS technique (first-arm) and the control group with the traditional case presentation method (2nd-arm) using a simple random number table by Microsoft Excel program, All residents was asked to prepare and present two different cases (per resident) according to their preferences during their daily training at health centers with a total of 60 case presentations (30 presentations for each group). data and feedback were gathered after each presentation using validated data recording sheets.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06484010
Sponsor's protocol ID
SNAPPS Iraq
Status last verified
Jun 2024
First submitted
25 Jun 2024
Last updated
3 Jul 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing SNAPPS Model of case presentation in people with Medical Education, run by Hawler Medical University at 1 site in Iraq.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Iraq. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Total presentation length (Time in Minutes) (time frame: 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 study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jul 2024.

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