SNAPPS Case Presentation Method and Clinical Reasoning in Midwifery Students

SNAPPS is a case presentation technique that has been shown to use the expression of clinical reasoning. This study aimed to evaluate the efficacy of SNAPPS and clinical reasoning in midwifery students in an ambulatory setting.

A semi experimental study with a pretest-posttest design was carried out on all 80 midwifery internship students in a women's health ambulatory setting (Tehran Medical Sciences Islamic Azad University) in 2020. A simple random allocation method was used to assign students to the intervention and conventional groups. The two groups were matched in terms of age and grade point average. Both groups participated in a virtual pretest including 40 multiple-choice questions identified as "must know". The intervention group was then subjected to the SNAPPS technique by watching videos over three 45-min sessions. Next, both groups attended in a two-week ambulatory rotation and after individual work in the case, the main investigator and four instructors recorded the data on a data-recording sheet. Both groups then participated in a posttest. Data were compared by independent t-test.

There was a statistically significant difference in favor of SNAPPS compared with the conventional group (P=0.000). The students of the SNAPPS technique summarized patients records more concisely (P<0.005), were clearer about their diagnostic hypothesis (P<0.005), and better differential diagnoses (P=0.002).

The SNAPPS technique provides the opportunity for expression of clinical reasoning which is highly challenging for instructors to evaluate in a standardized fashion