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SNAPPS facilitates clinical reasoning in outpatient settings

Medical students usually focus on factual information rather than diagnostic uncertainties and reasoning in their case presentations. Developing clinical reasoning in residents and medical students is a distinctive yet essential component and poses some challenges to medical educators. SNAPPS is a learner-centered approach to case presentations that has been shown to facilitate the expression of clinical reasoning and uncertainties in the outpatient setting. It was developed based on the cognitive learning (Bordage) and reflective practice theory (Osterman and Kottkamp). SNAPPS is a six-step technique (summarize history and findings, narrow the differential, analyze the differential, probe preceptor about uncertainties, plan management, select case-related issues for self-study) for case presentations in an outpatient setting. The SNAPPS technique offers a model for outpatient settings education by engaging learners and increasing collaborative as well as self-directed learning. This model encourages redirection of presentation to increase clinical reasoning and expression and links learner initiation and preceptor facilitation in an active learning conversation. The implication of the use of the SNAPPS model is in the strong precedent of the reflective practice and where the learner assumes the central role.