Comparing Modified Peer-Assisted and Traditional Instructor-Led Approaches in Defibrillation Training

OBJECTIVES: The modified Peyton 4-step teaching method is widely acknowledged for its efficacy in procedural skills training within medical education. In this study, the authors further modified the Peyton teaching method by shifting the instructor's role to a facilitative one and emphasizing a student-centered, peer-assisted learning structure. This randomized controlled study therefore aimed to compare the effectiveness of this further modified peer-assisted Peyton 4-step teaching method against a traditional instructor-led approach for teaching defibrillation to surgical residents. DESIGN: A randomized, single-blind, controlled study. SETTING: The study was conducted in the simulation training center of a university-affiliated tertiary hospital. PARTICIPANTS: Eighty-four surgical residents participating in American Heart Association basic cardiac life support training at the authors' hospital between January 2019 and December 2023. INTERVENTIONS: Participants were randomly assigned to either the experimental group (n = 42), which underwent training using the modified Peyton 4-step method featuring peer-guided practice, or the control group (n = 42), which received standard instructor-led training. MEASUREMENTS AND MAIN RESULTS: The effectiveness of the two methods was evaluated by comparing scores from theoretical knowledge tests, skills assessments, and questionnaire surveys. The theoretical knowledge test scores were 99.3 ± 2.6 for the experimental group of physicians and 98.3 ± 4.4 for the control group, with no statistically significant difference (p = 0.229). The experimental group demonstrated a higher correct recognition rate of shockable rhythms (92.9% v 76.2%) and more appropriate administration of resuscitation drugs (92.9% v 76.2%) than the control group, as well as fewer deviations from the standard algorithm during defibrillation compared with the control group (median [interquartile range (IQR)], 0.0 [0.0-1.0] v 1.0 [0.8-2.0]). In addition, the questionnaire survey results indicated that the experimental group reported higher levels of teaching satisfaction (median [IQR], 5 [5-5] v 4 [4-5]), greater learning interest (median [IQR], 5 [5-5] v 4 [4-5]), and stronger willingness to perform defibrillation promptly (median [IQR], 5 [5-5] v 4 [4-5]). These differences were all statistically significant (p < 0.05). CONCLUSIONS: The findings suggest that the modified Peyton 4-step approach enhances residents' proficiency in defibrillation and improves their learning experience, suggesting its value in clinical skills training.