Giacomino Katia, Caliesch Rahel, Sattelmayer Karl Martin
School of Health Sciences, HES-SO Valais-Wallis, Leukerbad, Switzerland.
PeerJ. 2020 Oct 9;8:e10129. doi: 10.7717/peerj.10129. eCollection 2020.
Acquisition 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.
We 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.
An 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.
Peyton'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.
技能习得是卫生专业教育的重要组成部分。传统上，技能教学采用“看一遍 - 做一遍”的方法。即教师演示并描述一项技能，然后学生练习该技能。Walker和Peyton提出了一种更新的技能习得教学方法。Peyton的教学方法是一种逐步教学法，包括以下四个步骤：演示、解构、理解和操作。本研究的目的是：（i）系统评估Peyton的四步教学法在卫生专业教育中技能习得方面的有效性；（ii）评估每位教师带教学生较少的研究是否比每位教师带教学生较多的研究显示出更大的组间差异。
我们在Medline、PsycInfo、Embase和ERIC中检索符合条件的研究。由两名独立评审员筛选记录。进行随机效应荟萃分析，以评估习得后测试和保留测试时的技能习得情况以及执行技能所需的时间。使用荟萃回归来探讨每位教师带教学生数量对教育干预估计效果的影响。
习得后测试时的效应量为0.45标准化均值差（95%置信区间[0.15; 0.75]），保留测试时为0.7标准化均值差（95%置信区间[-0.09; 1.49]），这支持Peyton的教学方法在技能习得方面的有效性。采用Peyton教学方法的组在习得后测试（标准化均值差：-0.8；95%[置信区间 -2.13至1.62]）和保留测试（标准化均值差：-2.65；95%置信区间[-7.77至2.47]）时执行技能所需的时间要少得多。在使用同伴教师的亚组分析中，Peyton教学方法的有效性不太明确。荟萃回归表明，每位教师带教学生的数量是一个重要的调节变量。
Peyton的教学方法是卫生专业教育中技能习得的有效教学方法。当使用同伴学生或学生导师作为教师时，Peyton教学方法的有效性不太明确。当使用每位教师带教学生较少的小组时，Peyton的教学方法更有效。
