(SOLUTION) NR511 Week 2: SNAPPS Presentation Assignment

Purpose

SNAPPS is a learner-centered approach to case presentation in the clinical setting. This model allows the student to take an active role in their educational encounter by discussing the patient encounter beyond the facts, verbalizing their clinical reasoning, asking questions, and engaging in follow-up learning pertinent to the educational encounter.  This exercise is designed to develop the student’s ability to organize patient information in a meaningful way and guide the student in their oral patient presentations in the clinical setting.   

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

  1. Summarize patient findings into an organized oral presentation. (WO2.3) (CO 5) 
  2. Identify their own knowledge gaps and inquire about uncertainties, difficulties, or alternative approaches to diagnosis & treatment of a patient. (WO2.3) (CO 5)    

Due Date:

The oral presentation and written assignment are due by Sunday 11:59 p.m. MT.

Total Points Possible:  100

Requirements:

  1. Using a patient seen in their clinical setting, students will give an oral presentation (via Kaltura) using the 6-step learner-centered SNAPPS model to mimic a real-life presentation to the preceptor by:
    • Briefly summarizing the relative history and findings;
    • Narrowing the differential to three relevant possibilities using the pertinent positive and negative findings;
    • Analyzing the differential by comparing and contrasting the possibilities;
    • Probing the preceptor by asking questions about uncertainties, difficulties, or alternative approaches;
    • Identifying a treatment plan for the patient; and
    • Select a case-related issue for self-directed learning
  1. In addition to the oral presentation, the student will submit the written findings of their research for the case-related, self-directed learning topic that was identified in the presentation.
  2. The written portion of this assignment will be submitted on the “SNAPPS Template for Written Assignment” using appropriate evidence-based, scholarly references and using appropriate APA reference and in-text citations.
  3. The oral presentation must be submitted to the Week 2 discussion board before Sunday, 11:59 p.m. MT. The written portion of the assignment must be submitted on the template provided to the assignment box before Sunday, 11:59 p.m. MT.  If any of the required items are missing or are submitted after the deadline, late penalties will be applied according to the Late Assignment Policy as discussion in the Syllabus.

Preparing the presentation and paper

The oral presentation part of this assignment should be prepared using the following guidelines:

  1. Students will present a patient seen in their clinical setting for a single, problem-focused (acute) visit.
  2. The oral presentation will be recorded and should mimic a presentation that would be given to the preceptor.
  3. The oral presentation must be recorded in Kaltura (slides are not required).
  4. The presentation should be 5-7min.
  5. The presentation should be shared with the class for viewing by posting a link in the Week 2 discussion board BEFORE Sunday 11:59pm MT.
  6. To help organize your data in preparation for the presentation, it is recommended that students use the “SNAPPS TEMPLATE FOR ORAL PRESENTATION”. This document is only a guide and is not required. It should NOT be submitted to the discussion board or assignment box.
  7. Students should refer to the SNAPPS videos in the Week 2 lesson as an example of the oral presentation.
  8. As part of the patient presentation, the student must provide the following:
    • Chief complaint with pertinent HPI, ROS and PE findings
    • Identification of the differential
    • An analysis of the differential with arguments for or against each diagnosis ranked in order from most likely to least likely
    • Probing questions that were asked of the preceptor or areas of uncertainties
    • Novice level plan management (diagnosis, medication, education and follow-up instructions)
  9. The student states the self-directed learning topic that they will investigate further. (NOTE: A self-directed learning topic is something that you want to know more about that relates to the condition, but is not the condition itself).

The written portion of this assignment should be prepared using the following guidelines:

  1. The student’s findings of the self-directed learning topic must be completed on the “SNAPPS WRITTEN ASSIGNMENT TEMPLATE”
  2. The report should be between 5-7 paragraphs in length, discussing something learned from the student’s research about the self-directed learning topic.
  3. Correct grammar, punctuation, and spelling should be observed.
  4. In-text citations and reference page should be written in APA format and scholarly evidence-based medicine (EBM) references must be used.
  5. The written report must be submitted to the Week 2 assignment box before Sunday 11:59pm MT.

SOLUTION

SNAPPS WRITTEN ASSIGNMENT TEMPLATE

 

What is the self-directed learning issue that was identified in your oral presentation?

 

Research the self-directed learning issue and provide a summary of your findings which is fully supported by appropriate, scholarly, EBM references.

 

Migraine is one of the most common complaints; currently, the condition affects 12% of the US population. Eighteen percent of migraine patients are female, 6% are male, and 10% are children (Migraine Research Foundation, 2020). While there are accessible medications for treating migraines, regular episodes still lower the quality of life for many patients. Sometimes, the pain is debilitating, and together with common symptoms, such as nausea, photo-, and phonophobia, it can prevent people from running their daily errands and enjoying preferred activities. Therefore, one of the crucial aspects of migraine management should be prevention. For this reason, patients are often advised to keep a migraine diary to identify aggravating factors. While triggers are often subjective, research is aimed toward general conclusions that could empower physicians and patients in their management of migraine.

There are compounds, such as glyceryl trinitrate and prostaglandin E2, that reliably trigger migraines. Yet, lower-intensity natural triggers are more difficult to predict, and their associations with the condition have yet to be elucidated. Marmura (2018) writes that in a study that analyzed the migraine diaries of 236 participants, 85% of profiles had unique aggravating factors. It was possible to generalize the findings, develop a classification of triggers. They were split into categories, such as environmental (odors (25.2%), lights (24.8%)), dietary (missed meals (20.6%), specific types of products), and psychological (private stress (10.6%), work stress (8.2%)) (Marmura, 2018). However, distinguishing between actual triggers and premonitory symptoms can be quite a challenge.

Dietary studies experience limitations ranging from the inability to use a placebo to research participants’ unreliability. For instance, it was commonly believed that chocolate could cause migraines. However, the causation was not confirmed by researchers that concluded that chocolate consumption was rather the consequence of increased appetite – a common premonitory migraine symptom (Marmura, 2018). The evidence regarding caffeine is mixed: when combined with analgesics, it is useful for treating acute migraines, but caffeine withdrawal may become a trigger on its own (Marmura, 2018). Lee, Choi, Choi, and Chang (2016) share conflicting findings as they link caffeine’s excitatory and vasoconstrictive impact on the central nervous system to the chronification of migraine. The study by Lee et al. (2016) showed that caffeine cessation and abstinence were effective in migration management. Another dietary and lifestyle choice, alcohol, may not be directly related to migraine headaches; its delayed effect is likely to be explained by its metabolite acetate (Marmura, 2018).

The rhythm of life today often results in poor diets, skipping meals, and lack of sleep, both of which may be migraine triggers. Gazerani (2020) finds that Ketogenic and modified Atkins diets were serving as protective factors against migraine headaches. It could be that diets poor in omega-6 and omega-3 fatty acids make individuals more prone to developing the condition. Marmura (2018) points to several studies that found higher migraine prevalence during religious fasting periods of Ramadan or Yom Kippur. Therefore, religious patients should reconsider their participation in practices or at least use medication such as frovatriptan (Marmura, 2018). Another lifestyle modification is improving the sleeping schedule as poor sleep quality has been found to be a common trigger (Marmura, 2018). The advanced sleep phase disorder and migraine are both explained by casein kinase Iδ mutations.

 

 

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