Peyton’s Four-step Method versus See One, Do One, Teach One Method for Acquisition of Ophthalmic Clinical Skills in Undergraduate Medical Students

Abstract Background: Clinical examination skills are conventionally taught using “see one, do one, teach one” (SODOTO) method, which has recently come under criticism. Peyton’s (four-step) model is claimed to be a better approach for skill teaching; nonetheless, research regarding its effectiveness in ophthalmic clinical skills is scanty. Aim: The study aims to compare the effectiveness of Peyton’s approach and the SODOTO method for acquiring ophthalmic clinical examination skills. Methodology: Forty Phase III Part 1 undergraduate medical students, who volunteered and consented to participate in the study, were divided by lottery method into two groups (Groups A and B), each comprising 20 participants. Pre-validated checklists were used for clinical skills teaching-learning and assessment by ophthalmic clinical evaluation exercise (OCEX). Student’s perception questionnaire sheet was prepared and validated by the subject experts. A pilot study was conducted on the residents. Theoretical instructions about torchlight examination (TLE) and slit-lamp examination (SLE) skills were given to the study participants, and resource materials were shared (on WhatsApp). TLE skills were demonstrated to Group A by the SODOTO method and to Group B by Peyton’s model and assessed by OCEX. The groups were crossed over for the teaching methodologies to teach SLE skills, and OCEX was conducted for assessment. The perception of students was recorded using the feedback questionnaire. Results: OCEX assessment scores of students who were taught clinical examination skills by Peyton’s model were significantly better than the SODOTO scores ( P = 0.008). Further, the OCEX score was significantly better ( P = 0.001) for students who were taught TLE skills by Peyton’s model. However, no difference was found between assessment scores of SLE skills taught by the SODOTO method and Peyton’s four-step approach ( P = 0.88). Students felt more confident in SLE skills taught by Peyton’s model ( P = 0.027). Conclusion: Peyton’s four-step model was found to be superior to the traditional SODOTO method.