Abstract
Objective
Suturing is a fundamental skill of medical professionals. Although Peyton’s four-step approach (demonstration, deconstruction, comprehension, and performance) has been tested and validated for numerous skills, one of its major limitations is its requirement for 1:1 instructor/student ratio. This study aimed to investigate the feasibility of modifying Peyton’s approach for small group teaching in the setting of suturing.
Design
Students were randomized into two groups, with one group taught using a modified Peyton’s approach, where students acted as the instructor for step 3, while another group was taught using a standard teaching approach. Suturing technique was assessed using an objective structured assessment of technical skill instrument and student feedback elicited through a Likert-type scale survey.
Setting
The study was conducted at Cabrini Hospital (Melbourne, Australia), a private tertiary-level hospital with an attached clinical school.
Participants
Twenty-three first clinical year students (third year) were invited to participate. Twenty-two students gave consent, and 12 students were allocated to group 1 (modified Peyton’s approach), and 10 students in group 2 (standard approach).
Results
Although the two groups were similar in their mean suturing scores and satisfaction, there was more consistency in suturing steps in group 1 versus group 2.
Conclusions
A modified Peyton’s approach using students only in step 3 was feasible in small group settings. Further studies, including comparison with Peyton’s original approach, are planned.
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Acknowledgments
We would like to thank the Cabrini Monash University Clinical School for their support in this research project. We acknowledge the generous support of Johnson & Johnson for the provision of suturing materials. This study was supported in part by “Let’s Beat Bowel Cancer” (www.letsbeatbowelcancer.com), a benevolent fund raising and public awareness foundation. The funder had no part in the design, conduct, outcomes, decision to publish, or the drafting of this manuscript.
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Ethics approval for this study was granted by Cabrini Human Research Ethics Committee (Approval No. 03-11-05-15). All participants consented to participate in the study and agreed for the use of the unidentified surveys and assessments for research.
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Yap, R., Moreira, A., Wilkins, S. et al. Suturing in Small Group Teaching Settings: a Modification to Peyton’s Four-Step Approach. Med.Sci.Educ. 26, 575–580 (2016). https://doi.org/10.1007/s40670-016-0296-x
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DOI: https://doi.org/10.1007/s40670-016-0296-x