Trial reportBMC medical education2016
Peyton's four-step approach for teaching complex spinal manipulation techniques - a prospective randomized trial.
Trial report in BMC medical education, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- The effect of real-time feedback on learning lumbar spine joint mobilization by entry-level doctor of physical therapy students: a randomized, controlled, crossover trial.The Journal of manual & manipulative therapy · 2020Trial
- The Role of Deconstructive Teaching in the Training of Laparoscopy.JSLS : Journal of the Society of Laparoendoscopic SurgeonsTrial
- Article
- Effectiveness of Demonstration Observation Assistance Performance (DOAP) and Video Assisted Learning (VAL) in teaching blood pressure measurement among MBBS students.Journal of education and health promotion · 2026Article
- The effect of a modified Peyton's four-step teaching method on orthokeratology skills: an experimental study.Frontiers in medicine · 2026Article
- Exploring medical student perceptions of a video-modified Peyton's 4-step technique for teaching spinal and neurological examinations.Medical education online · 2025Article
- The effect of Peyton's four-step method for teaching point-of-care ultrasound psychomotor skills: an experimental study.The ultrasound journal · 2025Article
- The effect of training methods on newly graduated physical therapists in Japan: A study of on-the-job and off-the-job training.Journal of education and health promotion · 2025Article
- Development of a basic evaluation model for manual therapy learning in rehabilitation students based on the Delphi method.BMC medical education · 2024Article
- Optimizing resident training in obstetrics and gynecology: a new perspective on the refined Peyton four-step teaching method.BMC medical education · 2024Article
- A novel model for developing thrust joint manipulation skills: a teaching and learning perspective.The Journal of manual & manipulative therapy · 2024Article
- Article
- Effectiveness of endotracheal intubation and mask ventilation procedural skills training on second-year student using modified Peyton's Four-Step approach during COVID-19 pandemic.Medical education online · 2023Article
- Frequently Used Conceptual Frameworks and Design Principles for Extended Reality in Health Professions Education.Medical science educator · 2022Article
- Efficacy and influencing factors of the four-step approach combining the situational simulation teaching method in the clinical practice of standardized training for residents.Health science reports · 2022Article
- Association Between Chiropractic Students' Hand-Eye Coordination or General Self-efficacy and Their Performance on a Spinal Manipulative Therapy Examination: A Cross-sectional Study.Journal of chiropractic medicine · 2021Article
- Surgical suture course for dental students with the Peyton-4-step approach versus the PDCA cycle using video assisted self-monitoring.BMC oral health · 2020Article
- Confronting the Challenges of Anatomy Education in a Competency-Based Medical Curriculum During Normal and Unprecedented Times (COVID-19 Pandemic): Pedagogical Framework Development and Implementation.JMIR medical education · 2020Article
- A Mixed-Methods Evaluation of Medical Residents' Attitudes Towards Interprofessional Learning and Stereotypes Following Sonography Student-Led Point-of-Care Ultrasound Training.Journal of general internal medicine · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objectives of this prospective randomized trial were to assess the impact of Peyton's four-step approach on the acquisition of complex psychomotor skills and to examine the influence of gender on learning outcomes.
methodsWe randomly assigned 95 third to fifth year medical students to an intervention group which received instructions according to Peyton (PG) or a control group, which received conventional teaching (CG). Both groups attended four sessions on the principles of manual therapy and specific manipulative and diagnostic techniques for the spine. We assessed differences in theoretical knowledge (multiple choice (MC) exam) and practical skills (Objective Structured Practical Examination (OSPE)) with respect to type of intervention and gender. Participants took a second OSPE 6 months after completion of the course.
resultsThere were no differences between groups with respect to the MC exam. Students in the PG group scored significantly higher in the OSPE. Gender had no additional impact. Results of the second OSPE showed a significant decline in competency regardless of gender and type of intervention.
conclusionsPeyton's approach is superior to standard instruction for teaching complex spinal manipulation skills regardless of gender. Skills retention was equally low for both techniques.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.