Evaluation of Peyton’s Four-Step Approach for Skill Acquisition in Undergraduate Medical Students: A Prospective Randomized Study

Background Skills laboratory training for procedural skills has gained a lot of significance in recent years. An instructional approach that is becoming increasingly prevalent in medical education is Peyton’s four-step approach which demonstrates benefit of peer learning under supervision of teachers. Aim The aim of this study was to determine the effect of application of Peyton’s four-step approach versus traditional learning on medical students’ performance. Objectives To compare the effectiveness of training effect of application of Peyton’s four-step approach versus traditional learning on medical students’ performance to measure blood pressure, and in performing hand washing procedures. As well as to assess and compare student self-satisfaction level and confidence level. Methodology The present prospective intervention study was carried out among 50 Medical students of Phase I MBBS by 4 faculty members with approval from the Institutional Ethics Committee. [Group A (intervention Group) and B (Control Group)], 25 students in each group were selected by using randomization. For the control group; the blood pressure measurement procedure and washing techniques were explained using the two-stage approach “see one, do one” and for the study group; each subgroup was trained to perform blood pressure measurement procedure and washing techniques using “Peyton’s four-step approach. A common scoring checklist for outcome evaluation was prepared to evaluate the student’s skills following the training session to avoid discrepancies in scoring among the faculties. Results It was found that in the control group 52% students were able to measure blood pressure and in study group 88% of students were able to do following skill sessions and in the control group 48% students were able to wash hands as per required protocol and in study group 96% of students were able to do following skill sessions. Regarding Students self-confidence and satisfaction levels, 24% were highly satisfied and confident in the control group as compared to 88% students among study group and a statistical difference was noted in confidence level in between two groups. Regarding the average and very good effectiveness of training, a statistical difference was found between control and study group. Conclusions Students who learnt through using Peyton’s four–step approach showed rapid learning, more confidence and exhibited higher competency in performing blood measurement procedure and hand washing techniques than those who learned through traditional method. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was granted by Institutional Ethics Committee, All India Institute of Medical Sciences, Rajkot, Gujarat, India. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors