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Ask …. And they will answer! Wolpay T et al. Student Uncertainties Drive Teaching During Case Presentations: More So With SNAPPS. Academic Medicine 2012;87(9):1210-1217.

Reviewed by Jonathan Gold

What was the study question?
When giving a case presentation, how do students who are trained to present using the SNAPPS tool differ in the types of questions and number of questions they ask compared to those students who present using a "traditional" approach? How do preceptors respond to these two different groups of students?

How was the study done?
Authors analyzed audio transcripts of students randomized to use either the SNAPPS technique for case presentations (Summarize history and findings; Narrow the differential; Analyze the differential; Probe preceptors about uncertainties; Plan management; Select case-related issues for self-study) or traditional case presentations to find out what kind of questions (ie uncertainties) the students asked about, and how often.

What are the results?
The students using the SNAPPS technique asked questions in every case, while the comparison group asked questions half the time. The questions asked by the SNAPPS group were more likely to be related to clinical reasoning than those asked by the other group. Preceptors were good at answering the kinds of questions that were asked.

What are the implications of these findings?
Students are good at following mnemonics and checklists. If we want students to think about clinical reasoning and to ask questions routinely, putting both of these items on a student checklist is a good way to make sure it happens.

Editor's note: When students drive their own learning, great things can happen. As the authors state, "No matter how busy preceptors are, no matter how many tasks they are balancing, they most often stop and teach when a student expresses an uncertainty. Preceptors are, in general, ready to teach at the 'drop of a question.'" Investing not only in faculty development – but also in student development – is a way to effectively drive learning (SLB).

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