Effectiveness of Various Teaching Methodologies in Developing Clinical Reasoning Skills in Undergraduate Female Medical Students.

Saima Ali; Brekhna Jamil; Liaqat Ali

Author(s)

Saima Ali Peshawar Medical College, Peshawar, Pakistan

Brekhna Jamil Khyber Medical University, Peshawar, Pakistan

Liaqat Ali Institute of Kidney Diseases (IKD), Hayatabad Medical Complex, Peshawar, Pakistan

Abstract

OBJECTIVE: To compare the effectiveness of “ summarize, narrow, analyze, probing, management plan, select a topic” (SNAPPS) model, one-minute preceptor (OMP) and traditional clinical teaching in developing clinical reasoning skills of final year undergraduate female medical students in pediatrics clinical setting. METHODS: This randomized control trial was conducted at Department of Pediatrics, Peshawar Medical College from February to July 2016. Students were randomly distributed in three groups i.e. SNAPPS, OMP and traditional teaching with 20 students in each group. All 60 students were exposed to pretest including 4 Key Feature Problems (KFPs). Students were then taught on pre-identified 4 topics with one topic /week by respective teaching methodology. Each topic was followed by post-test using 4 KFPs. The pre-test and post-test results were recorded and analyzed on SPSS-20. ANOVA was used as test for finding significance. RESULTS: All 60 female students of final year completed the study and none dropped out. The mean marks of pretest of three groups were 12.50±0.15 with minimum number of 4±1 marks and maximum of 23±1. There was no significant difference in pre-test among the groups using ANOVA (p=.984). However, significant difference (p<0.001) was observed in post-test among groups after intervention. There was statistically significant difference (p<0.001) in favor of SNAPPS as compared to traditional teaching methodology. There was no significant difference between OMP and traditional method. CONCLUSION: SNAPPS is significantly more effective in improving clinical reasoning than OMP and traditional teaching method in female undergraduate medical students in pediatrics clinical setting.

Publication Details

Page(s) 71-75

DOI DOI not available

Published Journal: Khyber Medical University Journal, Volume: 10, Issue: 2, Year: 2018

Request the full text from PASTIC

References

ElsteinAS, .Thinking about diagnostic thinking: A 30-year perspective,Adv Health Sci Educ Theory 10 7 -18

RamaniS,LeinsterS. AMEE,D O I, .Guide no. 34: Teaching in the clinical e n v i r o n m e n t . M e d Te a c h 2 0 0 8 ; 3 0 ( 4 ) : 3 4 7 - 6 4, 10 -

SpencerJ., 2003.ABC of learning and teaching in medicine: Learning and teaching in the clinical environment,BMJ 10 591 -4

WolpawTM,WolpawDR,PappKK, 2003.SNAPPS: A learner-centered model for outpatient education,Acad Med 78 893 -8

NeherJO,GordonKC,MeyerB,StevensN. A,Five-Step, 1992.Microskills” Model Of Clinical Teaching,J Am Board Fam Pract 5 419 -24

EvaKW, 01972.What every teacher needs to know about clinical reasoning,Med Educ 10 2929 -106

EdwardsI,JonesM,CarrJ,Braunack-MayerA,JensenGM, 2004.Clinical reasoning strategies in physical therapy,Phys Ther 84 312 -30

Paucard-DupontS,MarchandC., ., -

Exploratory study of clinical reasoning in nursing students with concept mapping,Rech Soins Infirm 85 -112

LockspeiserTM,KaulP, 2014.Applying the One Minute Preceptor Model to Pediatric and Adolescent Gynecology Education,J Pediatr Adolesc Gynecol 07 74 -7

AagaardE,TeheraniA,IrbyDM, 2004.Effectiveness of the one-minute preceptor model for diagnosing the patient and the learner: proof of concept,Acad Med 79 42 -9

FarrellSE,HopsonLR,WolffM,HemphillRR,SantenSA,D O I, 2016.What's the Evidence: A Review of the Oneminute Preceptor Model of Clinical Teaching and Implications for Teaching in the Emergency D e p a r t m e n t,e d 2 0 05 8 -3

SchmidtHG,BoshuizenHP, 1993.On the origin of intermediate effects in clinical case recall,Mem Cognit 21 338 -51

1990.N o r m a n G R , B o s h u i z e n H P. A c o g n i t i v e perspective on medical expertise: theory and implication,Acad Med 65 611 -21

LinnA,KhawC,KildeaH,TonkinA, 2012.Clinical reasoning: A guide to improving teaching and practice,Aust Fam Physician 41 18 -20

Levett-JonesT,HoffmanK,DempseyJ,JeongSY,NobleD,NortonCA, 2009.The “five rights” of clinical reasoning: An educational model to enhance nursing students' ability to identify and manage clinically “at risk” patients,Nurse Educ Today 10 515 -20

ArtinoAR,La RochelleJS,DezeeKJ,GehlbachH, 2014.Developing questionnaires for educational research:,AMEE Guide No. 87. Med Teach 10 463 -74

GayS,BartlettM,McKinleyR,D O I, .Teaching clinical reasoning to medical students,Clin Teach 2 10 8 -1

RencicJ, 2011.Twelve tips for teaching expertise in clinical reasoning,Med Teach 558142 887 -92

PageG,BordageG., 1995.The Medical Council of Canada's key features project: a more valid qritten examination of clinical decisionm a k i n g s k i l l s . A c a d, 70 104 -10

HrynchakP,TakahashiSG,Nayer M. K,D O I, .e y - f e a t u r e q u e s t i o n s f o r assessment of clinical reasoning: A literature review,Med Educ 2 10 0 -8

FarmerEA,PageG.,D O I, 2005.A practical guide to assessing clinical decisionmaking skills using the key features a p p r o a c h . M e d E d u c 2 0 0 5 ; 3 9 ( 1 2 ) : 1 1 8 8 - 9 4, 02339 2929 -

HeinerichsS,VelaLI,DrouinJM, 2013.A learner-centered technique and clinical reasoning, reflection, and case presentation attributes in athletic training students,J Athl Train 10 1062 -71

SawanyawisuthK,SchwartzA,WolpawT,BordageG, 2014.Expressing clinical reasoning and uncertainties during a Thai internal medicine ambulatory care rotation: Does the SNAPPS technique generalize,Med Teach 947942 379 -84

SekiM,OtakiJ,BreugelmansR,KomodaT,Nagata-KobayashiS,AkaishiY, 2016.How do case presentation teaching methods affect learning outcomes?-SNAPPS and the One-Minute preceptor,BMC Med Educ 10 12 -