Comparison of SNAPPS and Traditional Bedside Teaching in Enhancing Clinical Reasoning Skills Among 4th Year MBBS Students in Obstetrics and Gynecology

Authors

  • Ansa Islam Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar
  • Nowshad Asim Institute of Health Professions Education and Research(IHPER), Khyber Medical University (KMU) Peshawar
  • Bushra Mehboob Institute of Health Professions Education and Research(IHPER), Khyber Medical University (KMU) Peshawar
  • Brekhna Jamil Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar
  • Atyya Bibi Khan Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar
  • Usman Mahboob Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU), Peshawar

DOI:

https://doi.org/10.37762/jgmds.13-3.825

Keywords:

SNAPPS, Clinical Reasoning, Bedside Teaching, Obstetrics and Gynecology, Undergraduate Medical Education, MBBS Students

Abstract

ABSTRACT

OBJECTIVES

To compare the effectiveness of the SNAPPS model versus traditional bedside teaching in enhancing clinical reasoning and learning experiences among 4th-year MBBS students during Obstetrics and Gynecology ward rotations.

METHODOLOGY

A crossover comparative (within-subjects) study was conducted over six months among 43 fourth-year MBBS students at Ayub Medical Teaching Institute, Abbottabad. Each student experienced both traditional and SNAPPS-based bedside teaching. Student perceptions were gathered using a structured questionnaire, and ward test scores (out of 10) were analyzed. Data were processed using SPSS, and paired t-tests were used; p < 0.05 was considered significant.

RESULTS
SNAPPS-based teaching produced significantly higher mean scores in case summarization (p = 0.001), differential diagnosis (p = 0.001), management planning (p = 0.001), and total scores (p = 0.001), though no difference was observed in history/examination (p = 0.937). Student feedback showed strong agreement that SNAPPS improved clinical reasoning, confidence, and active participation, with higher overall satisfaction (39.14 ± 3.97 vs. 25.86 ± 4.15; p = 0.001).

CONCLUSION

The SNAPPS model significantly outperformed traditional bedside teaching in promoting clinical reasoning, analytical thinking, and student engagement among Obstetrics and Gynecology undergraduates. Its integration into ward teaching is recommended to foster reflective, learner-centered clinical education.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Ansa Islam, Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar

MHPE Scholar,
Institute of Health Professions Education and Research (IHPER),
Khyber Medical University (KMU) Peshawar.

Nowshad Asim, Institute of Health Professions Education and Research(IHPER), Khyber Medical University (KMU) Peshawar

Assistant Professor,
Institute of Health Professions Education and Research (IHPER),
Khyber Medical University (KMU) Peshawar

Bushra Mehboob, Institute of Health Professions Education and Research(IHPER), Khyber Medical University (KMU) Peshawar

Assistant Professor,
Institute of Health Professions Education and Research (IHPER),
Khyber Medical University (KMU) Peshawar

Brekhna Jamil, Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar

Professor,
Institute of Health Professions Education and Research (IHPER),
Khyber Medical University (KMU) Peshawar

Atyya Bibi Khan, Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU) Peshawar

MPHE Scholar,

Institute of Health Professions Education and Research (IHPER),

Khyber Medical University (KMU) Peshawar

Usman Mahboob, Institute of Health Professions Education and Research (IHPER), Khyber Medical University (KMU), Peshawar

Professor,
Institute of Health Professions Education and Research (IHPER),
Khyber Medical University (KMU), Peshawar

References

Harden RM, Sowden S, Dunn WR. Educational strategies in curriculum development: the SPICES model. Med Educ. 1984;18(4):284–97. https://doi.org/10.1111/j.1365-2923.1984.tb01024.x PMID: 6738482 DOI: https://doi.org/10.1111/j.1365-2923.1984.tb01024.x

Harden RM, Crosby JR. AMEE Guide No. 20: The good teacher is more than a lecturer—the twelve roles of the teacher. Med Teach. 2000;22(4):334–47. https://doi.org/10.1080/014215900409429 PMID: 21275420 DOI: https://doi.org/10.1080/014215900409429

Gordon M, Daniel M, Ajiboye A, Uraiby H, Xu NY, Bartlett R, Hanson J, Haas M, Spadafore M, Grafton-Clarke C, Gasiea RY. A scoping review of artificial intelligence in medical education: BEME Guide No. 84. Med Teach. 2024;46(4):446–70. https://doi.org/10.1080/0142159X.2024.2307560 PMID: 38231676 DOI: https://doi.org/10.1080/0142159X.2024.2314198

Shahzad S. Academic culture of Pakistani medical colleges. Health Prof Educ. 2020;6(1):59–64. https://doi.org/10.1016/j.hpe.2019.05.002 DOI: https://doi.org/10.53708/hpej.v3i1.186

Deng C, Gulseren D, Isola C, Grocutt K, Turner N. Transformational leadership effectiveness: an evidence-based primer. Hum Resour Dev Int. 2023;26(5):627–41. https://doi.org/10.1080/13678868.2022.2135938 DOI: https://doi.org/10.1080/13678868.2022.2135938

Magaña-Medina DE, Aquino-Zúñiga SP, Valdés-Cuervo AA, Parra-Pérez LG. Transformational leadership and the learner-centred teaching approach. S Afr J Educ. 2021;41(2):1–12. https://doi.org/10.15700/saje.v41n2a1900 DOI: https://doi.org/10.15700/saje.v41ns2a1932

Qazi MA, Aman F, Jadoon M, Rafique M, Khan S, Khan RB. Implementation and evaluation of a needs-based faculty development programme in a medical college of Pakistan: a mixed methods action-research. J Pak Med Assoc. 2025;75(11):1714–9. https://doi.org/10.47391/JPMA.12793. PMID: 40920734 DOI: https://doi.org/10.47391/JPMA.20922

Norman G. Research in clinical reasoning: past history and current trends. Med Educ. 2005;39(4):418–27. https://doi.org/10.1111/j.1365-2929.2005.02127.x PMID: 15813766 DOI: https://doi.org/10.1111/j.1365-2929.2005.02127.x

Pascoe JM, Nixon J, Lang VJ. Maximizing teaching on the wards: review and application of the One-Minute Preceptor and SNAPPS models. J Hosp Med. 2015;10(2):125–30. https://doi.org/10.1002/jhm.2296 PMID: 25521426 DOI: https://doi.org/10.1002/jhm.2302

Schmidt HG, Mamede S. How to improve the teaching of clinical reasoning: a narrative review and a proposal. Med Educ. 2015;49(10):961–73. https://doi.org/10.1111/medu.12775 PMID: 26212625 DOI: https://doi.org/10.1111/medu.12775

Ali S, Jamil B, Ali L. Effectiveness of various teaching methodologies in developing clinical reasoning skills in undergraduate female medical students. Khyber Med Univ J. 2018;10(2):84–8. https://doi.org/10.35845/kmuj.2018.17766 DOI: https://doi.org/10.35845/kmuj.2018.17766

Mohamed ER, Almulhem MA, AlElq AH, Zeeshan M, Alharbi RS, Almuhanna AE, et al. Obstetrics and gynecology patients' perceptions about bedside teaching at a Saudi teaching hospital. J Fam Community Med. 2024;31(2):168–75. https://doi.org/10.4103/jfcm.jfcm_229_23 PMID: 38687149 DOI: https://doi.org/10.4103/jfcm.jfcm_229_23

Wolpaw TM, Wolpaw DR, Papp KK. SNAPPS: a learner-centered model for outpatient education. Acad Med. 2003;78(9):893–8. https://doi.org/10.1097/00001888-200309000-00010 PMID: 14507619 DOI: https://doi.org/10.1097/00001888-200309000-00010

Jain V, Rao S, Jinadani M. Effectiveness of SNAPPS for improving clinical reasoning in postgraduates: a randomized controlled trial. BMC Med Educ. 2019;19(1):224. https://doi.org/10.1186/s12909-019-1670-3 PMID: 31291991 DOI: https://doi.org/10.1186/s12909-019-1670-3

Gopinath D, Narayan R. Effectiveness of One-Minute Preceptor model and SNAPPS model as clinical tools for postgraduate teaching: a comparative study. Int J Sci Res. 2023;12(1):45–49 DOI: https://doi.org/10.36106/ijsr/9215359

Sivaraman A. Effectiveness of SNAPPS teaching model in general surgery for improving critical thinking and clinical reasoning skills in Phase III MBBS students: a prospective randomized mixed-methods study. Int J Sci Res. 2025;14(2):34–8 DOI: https://doi.org/10.36106/ijsr/5710642

Barangard H, Afshari P, Abedi P. The effect of the SNAPPS method versus teacher-centered education on clinical gynecology skills of midwifery students in Iran. J Educ Eval Health Prof. 2016;13:25. https://doi.org/10.3352/jeehp.2016.13.25 PMID: 27493963 DOI: https://doi.org/10.3352/jeehp.2016.13.41

Feijó LP, Pereira GA, Ruffini V, Valente F, Dos Santos RA, Fakhouri Filho SA, et al. Effectiveness of SNAPPS in psychiatric residents assessed using objective structured teaching encounters: a case-control study. Sao Paulo Med J. 2022;140(4):359–65. https://doi.org/10.1590/1516-3180.2021.1028.R1.13072022 PMID: 36259849 DOI: https://doi.org/10.1590/1516-3180.2021.1028.r1.13072022

Khasbage S, Vagha S, Bhowate R. Efficacy of SNAPPS in critical thinking and understanding by dental undergraduates in oral medicine. J Clin Med Educ. 2018;9(1):23–30 DOI: https://doi.org/10.5455/jcme.20180107012322

Grünewald STF, Grünewald T, Ezequiel ODS, Lucchetti ALG, Lucchetti G. One-minute preceptor and SNAPPS for clinical reasoning: a systematic review and meta-analysis. Intern Med J. 2023;53(4):452–60. https://doi.org/10.1111/imj.16005 PMID: 36448464 DOI: https://doi.org/10.1111/imj.16005

Teixeira SFG, Grünewald T, Ezequiel ODS, Lucchetti ALG, Lucchetti G. One-Minute Preceptor, SNAPPS, and traditional teaching in the acquisition of clinical reasoning skills by medical students. Med Educ. 2017;51(8):823–35. https://doi.org/10.1111/medu.13022 PMID: 28480606 DOI: https://doi.org/10.1007/s40670-024-02241-3

Flores-Cohaila JA, Vizcarra-Jiménez SF, Bermúdez-Peláez MF, Váscones-Román FF, Rivarola-Hidalgo M. Effects of SNAPPS in clinical reasoning teaching: a systematic review with meta-analysis of randomized controlled trials. Diagnosis (Berl). 2024;11(3):123–31. https://doi.org/10.1515/dx-2023-0149 PMID: 38349856 DOI: https://doi.org/10.1515/dx-2023-0149

van der Leeuw RM, Lombarts KMJMH, Heineman MJ, Arah OA. Systematic evaluation of the teaching qualities of obstetrics and gynecology faculty: reliability and validity of the SETQ tools. PLoS One. 2011;6(5):e19142. https://doi.org/10.1371/journal.pone.0019142 PMID: 21559275 DOI: https://doi.org/10.1371/journal.pone.0019142

Bhardwaj V, Zhang S, Tan YQ, Pandey V. Redefining learning: student-centered strategies for academic and personal growth. Front Educ. 2025;10:1518602. https://doi.org/10.3389/feduc.2025.1518602 DOI: https://doi.org/10.3389/feduc.2025.1518602

Wolpaw T, Papp KK, Bordage G. Using SNAPPS to facilitate the expression of clinical reasoning and uncertainties: a randomized comparison group trial. Acad Med. 2009;84(4):517–24. https://doi.org/10.1097/ACM.0b013e31819a8cbf PMID: 19318792 DOI: https://doi.org/10.1097/ACM.0b013e31819a8cbf

Wolpaw T, Côté L, Papp K, Bordage G. Student uncertainties drive teaching during case presentations: more so with SNAPPS. Acad Med. 2012;87(9):1211–7. https://doi.org/10.1097/ACM.0b013e3182628fa4 PMID: 22836838 DOI: https://doi.org/10.1097/ACM.0b013e3182628fa4

Ramazanzade K, Ebrahimzade A. Comparison of the effect of two clinical education methods—SNAPPS and conventional—on medical students' clinical reasoning skills. Iran J Med Educ. 2018;18:107–13

Alam NN, Haque S, Khain IK, Mushroor S. Perspectives of medical students on attributes of bedside teaching. Int J Community Med Public Health. 2020;7(5):1652–6. https://doi.org/10.18203/2394-6040.ijcmph20201962 DOI: https://doi.org/10.18203/2394-6040.ijcmph20201962

Chen J, Chen X, Wu Y, Shi W. Application of SNAPPS combined with One-Minute Preceptor teaching method in emergency internship training. Creat Educ. 2022;13(3):778–87. https://doi.org/10.4236/ce.2022.133050 DOI: https://doi.org/10.4236/ce.2022.135100

Sawanyawisuth K, Schwartz A, Wolpaw T, Bordage G. Expressing clinical reasoning and uncertainties during a Thai internal medicine ambulatory care rotation: does the SNAPPS technique generalize? Med Teach. 2015;37(5):456–60. https://doi.org/10.3109/0142159X.2014.947936 PMID: 25154742 DOI: https://doi.org/10.3109/0142159X.2014.947942

Downloads

Published

2026-06-30

How to Cite

Islam, A., Asim, N. ., Mehboob, B., Jamil, B., Bibi Khan, A. ., & Usman Mahboob. (2026). Comparison of SNAPPS and Traditional Bedside Teaching in Enhancing Clinical Reasoning Skills Among 4th Year MBBS Students in Obstetrics and Gynecology. Journal of Gandhara Medical and Dental Science, 13(3), 29–34. https://doi.org/10.37762/jgmds.13-3.825

Most read articles by the same author(s)

1 2 > >> 

Similar Articles

You may also start an advanced similarity search for this article.