Zeynab Abbasi Senjedari - Midwifery Department, Nursing and Midwifery School, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
Akram Peyman - Midwifery Department, Nursing and Midwifery School, Tehran Medical Sciences Islamic Azad University, Tehran, Iran.
Mehrandokht Nekavand - Midwifery Department, Nursing and Midwifery School, Tehran Medical Sciences Islamic Azad University, Tehran, Iran.

Background and Aim: 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. Materials and Methods: A semi experimental study with a pretest-posttest design was carried out on all ۸۰ midwifery internship students in a women's health ambulatory setting (Tehran Medical Sciences Islamic Azad University) in ۲۰۲۰. 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 ۴۰ multiple-choice questions identified as "must know". The intervention group was then subjected to the SNAPPS technique by watching videos over three ۴۵-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. Results: There was a statistically significant difference in favor of SNAPPS compared with the conventional group (P=۰.۰۰۰). The students of the SNAPPS technique summarized patients records more concisely (P<۰.۰۰۵), were clearer about their diagnostic hypothesis (P<۰.۰۰۵), and better differential diagnoses (P=۰.۰۰۲). Conclusion: The SNAPPS technique provides the opportunity for expression of clinical reasoning which is highly challenging for instructors to evaluate in a standardized fashion

Ambulatory Education, Model, Learning, Clinical Reasoning