Application of a modified Peyton’s four-step approach in clinical skills training for residents: a randomized controlled trial

BACKGROUND: Peyton's four-step approach is a common teaching method in medical resident training. However, it has shortcomings such as long teaching duration, low efficiency, and poor long-term retention. This study proposed a modified Peyton's four-step approach and explored its effectiveness in teaching clinical skills for wound dressing and suture removal to residents. METHODS: One hundred and twenty residents were selected and randomly divided into an experimental group (n = 60) and a control group (n = 60). The experimental group received training using the modified Peyton's four-step approach, while the control group received training using the traditional Peyton's four-step approach. Teaching outcomes were evaluated by assessing residents' clinical skills through objective structured clinical examinations (OSCEs) and administering questionnaires immediately after training and one month later. RESULTS: After training, the OSCE scores of the experimental group (94.80 ± 3.02) were higher than those of the control group (93.15 ± 2.62). Notably, one month after training, the OSCE scores of the experimental group (94.13 ± 2.00) remained significantly higher than those of the control group (88.30 ± 4.89). These differences were statistically significant (p < 0.05). Questionnaire surveys indicated that residents in the experimental group believed the modified Peyton's four-step approach better stimulated learning interest, improved active learning, enhanced teamwork, and strengthened clinical skills. Satisfaction with the teaching method was also higher in the experimental group compared to the control group (p < 0.05). CONCLUSION: The modified Peyton's four-step approach demonstrates significant teaching effectiveness in the clinical skills training of residents. It not only improves the level of clinical operational skills but also enhances teaching efficiency and short- to medium-term skill retention, making it a superior teaching model worthy of promotion.