Modification of Peyton’s four-step approach for small group teaching – a descriptive study

Abstract

BackgroundSkills-lab training as a methodological teaching approach is nowadays part of the training programs of almost all medical faculties. Specific ingredients have been shown to contribute to a successful learning experience in skills-labs. Although it is undoubted that the instructional approach used to introduce novel clinical technical skills to learners has a decisive impact on subsequent skills performance, as yet, little is known about differential effects of varying instructional methods. An instructional approach that is becoming increasingly prevalent in medical education is “Peyton’s Four-Step Approach”. As Peyton’s Four Step Approach was designed for a 1:1 teacher : student ratio, the aim of the present study was to develop and evaluate a modified Peyton’s Approach for small group teaching.MethodsThe modified Peyton’s Approach was applied in three skills-lab training sessions on IV catheter insertion, each with three first- or second year medical students (n = 9), delivered by three different skills-lab teachers. The presented descriptive study investigated the practicability and subjective impressions of skills-lab trainees and tutors. Skills-lab sessions were evaluated by trainees’ self-assessment, expert ratings, and qualitative analysis of semi-standardized interviews conducted with trainees and tutors.ResultsThe model was well accepted by trainees, and was rated as easy to realize, resulting in a good flow of teaching and success in attracting trainee’s attention when observed by expert raters. Qualitative semi-standardized interviews performed with all of the trainees and tutors revealed that trainees valued repeated observation, instruction of trainees and the opportunity for independent performance, while tutors stressed that trainees were highly concentrated throughout the training and that they perceived repeated observation to be a valuable preparation for their own performance.ConclusionThe modified Peyton’s Approach to instruct small groups of students in skills-lab training sessions has revealed to be practicable, well accepted by trainees, and easy for tutors to realize. Further research should address the realization of the model in larger skills-lab training groups.

Intraosseous access can be taught to medical students using the four-step approach

“…The approach is developed for 1:1 teaching but students also welcome it for small group training [24]. The use of this teaching method at a cadaver course may increase focus on making use of this teaching method when teaching medical students and other novice learners practical skills outside the simulation centre or skill lab.…”

Using Gagne’s instructional model in phlebotomy education

“…This practice concurs with the law of primacy10 and the first step in the Peyton’s four-step approach to teaching (demonstration–deconstruction–comprehension–performance) 17. To begin, I “demonstrate” how I approach the patient politely, identify the patient correctly, label the blood tubes rightfully and dispatch the blood tubes in a timely manner.…”

Practical Clinical Training in Skills Labs: Theory and Practice

“…Though the procedure described above focuses a one-on-one learning situation, a modified version of the approach has also proven to be applicable for the instruction of small groups, typically found in skills lab training settings [31]. …”