One-Minute Preceptor, SNAPPS, and Traditional Teaching in the Acquisition of Clinical Reasoning Skills by Medical Students

Despite growing evidence on teaching tools to improve clinical reasoning (CR), there is still uncertainty about which tool is more appropriate and leads to better outcomes.

To evaluate the effectiveness of one-min preceptor (OMP) and SNAPPS (summarize relevant findings, narrow the differential, analyze, probe the preceptor, plan management, select issues for self-study) models compared to traditional teaching in CR skills acquisition by medical students.

A randomized controlled trial where students were enrolled into three arms: OMP, SNAPPS, and traditional teaching (control arm). They were evaluated before and after their pediatrics clerkship rotation, both in a simulated environment and with real patients, on several CR-related outcomes and the quality of clinical case presentations.

A total of 256 students were randomized (86 control, 83 OMP, 87 SNAPPS), with no significant baseline differences. After the clerkship rotation, both intervention arms performed significantly better than the control arm. SNAPPS produced better results than OMP in the simulated environment for discussion time, case presentation quality score, student performance score, and the number of differential diagnoses presented and justified. In real medical settings, SNAPPS was superior to OMP for case presentation quality score. OMP was better evaluated than SNAPPS regarding satisfaction with the use of the tool, and both tools were superior to traditional teaching.

Clinical reasoning is an important outcome for medical training, and the use of CR tools can improve student performance. While SNAPPS had better results in CR-related outcomes and clinical case presentation, OMP received higher satisfaction scores.