ArticlePeerJ2020
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.
Article in PeerJ, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 60 papers.
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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.
The Effect Of Prenatal Care Training Using The Peyton Model On Midwifery Students' Knowledge, Skills, Self-Efficacy, Anxiety, And Satisfaction Levels
Comparison of Peyton's Four-Step Approach and Halsted's 'See One, Do One' Method for Teaching Basic Surgical Skills: A Randomised Study Assessing Long-Term Retention in a Pakistani Medical School
Who cites it
60 citing papers in PubMed.
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- Assessing Best Practices in a Simulated Lumbar Puncture Workshop With Medical Students.The Permanente journal · 2025Trial
- A quasi-experimental comparison of Kolb and Peyton educational approaches on CPR knowledge and performance among nurses.BMC medical education · 2025Trial
- Juxtaposing pedagogical paradigms: the efficacy of peer-assisted learning (PAL) versus faculty-assisted learning (FAL) in the refinement of surgical proficiency.BMC medical education · 2025Trial
- Enhancing cosmetic suturing skill acquisition in surgical residents through spaced learning training: a randomized controlled trial.Annals of medicine · 2024Trial
- Trial
- From tradition to innovation: a comparison of the traditional 4-step approach versus a blended learning modification for technical skills teaching.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Trial
- Reflective practice improves Basic Life Support training outcomes: A randomized controlled study.PloS one · 2023Trial
- Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Randomized Controlled Trial.International journal of environmental research and public health · 2022Trial
- The 10-year evolution of a dental undergraduate 'Blended Learning' suturing programme.BDJ open · 2026Article
- Lecture, model, or both? Optimizing fracture education with 3D printing: a longitudinal interventional study.3D printing in medicine · 2026Article
- Strengthening simulation design and cultural safe practice: end-user evaluation of the quality simulation assurance framework.Advances in simulation (London, England) · 2026Article
- Taking microvascular training through the elevator: institutional experience in structured microsurgical training in India.Maxillofacial plastic and reconstructive surgery · 2026Article
- A novel 'Blended Pedagogy' for integrating bioinformatics into the undergraduate medical curriculum: a pilot study on feasibility and student engagement.BMC medical education · 2026Article
- Article
- A comparative analysis on the perceptions of Chinese dentists and dental students towards the practical course of stabilization occlusal splint fabrication.BMC medical education · 2026Article
- Video-Based Evaluation of Checklist Adherence on a Neonatal Intensive Care Unit: A Prospective Observational Study.Acta paediatrica (Oslo, Norway : 1992) · 2026Observational
- Basic Bronchoscopy Competence Achieved During a One-Day Workshop for a Multidisciplinary Critical Care Team:Sultan Qaboos University medical journal · 2026Article
- The effect of a modified Peyton's four-step teaching method on orthokeratology skills: an experimental study.Frontiers in medicine · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcquisition 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.
methodsWe 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.
resultsAn 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.
conclusionPeyton'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.
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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.