The effectiveness of the Peyton’s 4-step teaching approach on skill acquisition of procedures in health professions education: A systematic review and meta-analysis with integrated meta-regression

Abstract

Background Acquisition of procedures is an important element in health professions education. Traditionally procedures are taught using a “see one - do one” approach. That is a teacher demonstrates and describes a procedure and afterwards the students practice the procedure. A more recent teaching approach for the acquisition of procedural skills was presented by Walker and Peyton. Peyton’s teaching approach is a stepwise teaching approach and consists of the following four steps: demonstration, deconstruction, comprehension and performance. The aims of this study were (i) to systematically evaluate the effectiveness of Peyton’s 4–step teaching approach on the acquisition of procedural skills in health professions education and (ii) to evaluate whether studies with fewer students per teacher showed a larger between group difference than studies with more students per teacher. Methods We searched in Medline, PsycInfo, Embase and ERIC for eligible studies. Records were screened by two independent reviewers. A random effects meta-analysis was performed to evaluate skill acquisition and time needed to perform the procedures at post-acquisition and retention tests. A meta-regression was used to explore the effect of the number of students per teacher on the estimated effect of the educational interventions. Results An effect size of 0.45 SMD (95% CI [0.15; 0.75]) at post-acquisition and 0.7 SMD (95% CI [−0.09; 1.49]) at retention testing were in favour of Peyton’s teaching approach for skill acquisition. The groups using Peyton’s teaching approach needed considerably less time to perform the procedure at post-acquisition (SMD: −0.8; 95% [CI −2.13 to 1.62]) and retention (SMD: −2.65; 95% CI [−7.77 to 2.47]) testing. The effectiveness of Peyton’s teaching approach was less clear in subgroup analyses using peer teachers. Meta-regression showed that the number of students per teacher was an important moderator variable. Conclusion Peyton’s teaching approach is an effective teaching approach for skill acquisition of procedural skills in health professions education. When peer students or student tutors are used as teachers the effectiveness of Peyton’s teaching approach is less clear. Peyton’s teaching approach is more effective when small groups with few students per teacher are used.

Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Protocol for a Randomized Controlled Trial

“…Indeed, these students who will be trained as an instructor within the framework of the study have no expertise in either IPC or in teaching, and have no or little experience in their profession and as an instructor. When peer students or student tutors are used as teachers, the effectiveness of the Peyton teaching approach is less clear [ 15 ].…”

“…The instructors will receive a detailed PPE doffing procedure validated by infection prevention and control (IPC) experts ( Multimedia Appendix 2 ) and a summary sheet of the Peyton approach steps ( Multimedia Appendix 3 ). The instructor:learner ratio will range from 1:1 to 1:3 as such ratios have been shown to be particularly efficient [ 15 ].…”

“…It was therefore concluded that e-learning training alone is insufficient to adequately train prehospital staff in the noncontaminating removal of PPE, and that other training modalities should be considered, either as standalone interventions or in combination with this module. The Peyton 4-step teaching approach [ 14 ] is an effective training structure that has been shown to increase knowledge and skill retention when compared to standard training in the acquisition of procedural skills [ 15 ]. Our hypothesis is that adding a face-to-face training modality using the Peyton 4-step approach to a gamified e-learning module could increase the proficiency of prehospital workers regarding this procedure, thus reducing the risk of contamination of prehospital staff [ 16 ].…”

Effect on Chest Compression Fraction of Continuous Manual Compressions with Asynchronous Ventilations Using an i-gel® versus 30:2 Approach during Simulated Out-of-Hospital Cardiac Arrest: Protocol for a Manikin Multicenter Randomized Controlled Trial

“…Then, the use of the i-gel ® device use will be taught by one of the investigators (LSt) in accordance with Peyton’s approach [ 41 , 42 ], because this approach has shown superiority [ 43 ], and is based on a standard operating procedure ( Supplementary Files S3 and S4 ) created by study investigators following the manufacturer’s instructions:…”

Effect of Early Supraglottic Airway Device Insertion on Chest Compression Fraction during Simulated Out-of-Hospital Cardiac Arrest: Randomized Controlled Trial

“…The use of the i-gel® device was taught to each team separately by one of the investigators (LSt) in accordance with Peyton's approach [43][44][45] , based on a standard operating procedure (Supplementary Files S2, S3). Twenty minutes were dedicated to this workshop.…”