Use of SNAPPS Model for Pediatric Outpatient Education.

Objective: To assess and compare the educational effectiveness of SNAPPS model with traditional method in developing reasoning skills of Pediatric residents in Out-patient department.

Methods: 40 case presentations with 4 residents (20 each with traditional and SNAPPS methods) were audiotaped and compared with respect to making differentials, reasoning for analyzing differentials, raising uncertainties by probing preceptor, and selecting case-related issues for self study. Residents feedback was collected using a self-designed proforma.

Vomiting and food refusal causing failure to thrive in a 2 year old: an unusual and late manifestation of congenital duodenal web.

Congenital duodenal anomalies like atresia, stenosis and web or diaphragm commonly present in the neonatal age with signs of intestinal obstruction. Duodenal webs can sometimes present in early infancy and very rarely beyond infancy. The authors present a case of congenital duodenal web with a very small central aperture in a 2-year-old child with presenting features of persistent vomiting and resultant failure to thrive without any overt signs of intestinal obstruction.