Comparing video-based versions of Halsted’s ‘see one, do one’ and Peyton’s ‘4-step approach’ for teaching surgical skills: a randomized controlled trial

Abstract

Background: Teaching complex motor skills at a high level remains a challenge in medical education. Established methods often involve large amounts of teaching time and material. The implementation of standardized videos in those methods might help save resources. In this study, video-based versions of Peyton's '4-step Approach' and Halsted's 'See One, Do One' are compared. We hypothesized that the video-based '4-step Approach' would be more effective in learning procedural skills than the 'See One, Do One Approach'. Methods: One-hundred-two naïve students were trained to perform a structured facial examination and a Bellocq's tamponade with either Halsted's (n = 57) or Peyton's (n = 45) method within a curricular course. Steps 1 (Halsted) and 1-3 (Peyton) were replaced by standardized teaching videos. The performance was measured directly (T1) and 8 weeks (T2) after the intervention by blinded examiners using structured checklists. An item-analysis was also carried out. Results: At T1, performance scores significantly differed in favor of the video-based '4-step Approach' (p < 0.01) for both skills. No differences were found at T2 (p < 0.362). The item-analysis revealed that Peyton's method was significantly more effective in the complex subparts of both skills. Conclusions: The modified video-based version of Peyton's '4-step Approach' is the preferred method for teaching especially complex motor skills in a large curricular scale. Furthermore, an effective way to utilize Peyton's method in a group setting could be demonstrated. Further studies have to investigate the long-term learning retention of this method in a formative setting.

Teaching rotary root canal instrumentation using a Peyton teaching approach

“…We assume that verbalization and subsequent instruction of a complex motor skill or procedure, which is evident in step 3 of the Peyton's 4‐step approach contributes to a more profound cognitive processing and hence, to a better implementation of the treatment steps. These findings are corroborated by a recent study on surgical skills of medical students where the Peyton‐4‐step approach resulted in significantly better performance scores compared to the conventional “see one–do one” approach 30 …”

Operative Ausbildungsziele in der Plastischen und Ästhetischen Chirurgie einfach „SMART“

“…Mit dem "see one, do one, teach one"-Prinzip von Halsted wurde eine Gliederung in mehrere, aufeinander aufbauende Einzelschritte initiiert [7,8]. Aus heutiger Sicht wirkt dieses Prinzip auch unter dem Aspekt der Patientensicherheit antiquiert [6,8].…”

“…Das Erlernen manueller Fertigkeiten in chirurgischen Fächern erfolgt häufig unstrukturiert und zufällig während der Tätigkeit [6]. Mit dem "see one, do one, teach one"-Prinzip von Halsted wurde eine Gliederung in mehrere, aufeinander aufbauende Einzelschritte initiiert [7,8]. Aus heutiger Sicht wirkt dieses Prinzip auch unter dem Aspekt der Patientensicherheit antiquiert [6,8].…”

Is “See One, Do One, Teach One” The Best Way to Learn Procedures?

“…In fact, Peyton's 4‐step model of demonstration, deconstruction, comprehension, and performance has been shown to be a valid method of teaching complex motor skills (Table I). 3 Peyton's model has been shown to be superior in teaching complex motor skills with improved short‐term retention to Halstead's approach 3 . As such, formative feedback to foster learning and improve behavior 1 is becoming a more standard method in surgical education.…”