Document Type : Original Article

Authors

Department of Medical Education, Medical Education Development Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

INTRODUCTION: The ability of physicians to perform endotracheal intubation by laryngoscope is one
of the essential skills. The purpose of this study was to evaluate the effectiveness of the four‑step
python training method with the Halsted’s “See one, Do one, and Teach one” training method in
endotracheal intubation competency in simulated environment.
MATERIALS AND METHODS: This quasi‑experimental study was performed on two independent
groups with posttest. The statistical society consisted of eighth‑semester medical students referred
to the emergency medicine unit. The experimental group received a modified four‑step python‘s
training method that modified for small groups, and the control group received the Halsted’s “See
one, Do one, and Teach one” training method. Researcher‑made checklist used to rate participant
competency as posttest. Data were analyzed using SPSS 19 software.
RESULTS: Sixty‑seven students volunteered for the experimental group and 57 students for
the control group. In posttest, the experimental group more competent than the control group
significantly (P < 0.001). Furthermore, the training course satisfaction of the experimental group was
significantly higher than the control group (P < 0.001).
DISCUSSION AND CONCLUSION: Modified python training method for small groups has shown
a better effect on student performance. This finding is consistent with previous researches.
Modified four‑step python’s training for small group with an emphasis on peer to peer teaching and
receiving feedback from peer can be related to the effectiveness of this training. Further research is
recommended in other clinical education settings.

Keywords

  1. Saeedi M, Hajiseyedjavadi H, Seyedhosseini J, Eslami V,
    Sheikhmotaharvahedi H. Comparison of endotracheal intubation,
    combitube, and laryngeal mask airway between inexperienced
    and experienced emergency medical staff: A manikin study. Int
    J Crit Illn Inj Sci 2014;4:303‑8.
    2. Mousavipour S, Samadi K. The evaluation knowledge and use of
    general practitioners and interns from intubation with medication.
    Horizon Med Sci 2018;24:203‑13.
    3. Alsaied OA, Chipman JG, Brunsvold ME. Simulation in critical
    care. Comprehensive Healthcare Simulation: Surgery and Surgical
    Subspecialties. Switzerland: Springer; 2019. p. 253‑61.
    4. Etezadi F, Najafi A, Pourfakhr P, Shariat Moharari R, Reza
    Khajavi M, Imani F, et al. An assessment of intubation skill
    training in novice anesthesiology residents of Tehran University
    of medical sciences with the use of mannequins. Anesth Pain Med
    2016;6:e39184.
    5. Aghamohammadi D, Khanbabaee GM, Farzin H. The effect of
    intubation intubation training on the success of cardiopulmonary
    resuscitation in medical students‑2015. Iran J Assoc Anesthesiol
    Intensive Care 2017;98:8.
    6. Khazaei T, Makhmalbaf G, Sharifzadeh G. Comparing two
    methods of teaching ventilation skills, laryngoscopy and tracheal
    intubation, in anesthesiology students. Iran J Med Educ 2010;
    9:225-30.
    7. Seidabadi M, Kohankhaki AH, MohammadiR, Raziani F, Ezzati E,
    Mohammadi A. Endotracheal intubation and airway management
    skills of Iranian freshman emergency medical students in 2014.
    Int J Adv Biotechnol Res 2016;7:1241‑9.
    8. Romero P, Günther P, Kowalewski KF, Friedrich M, Schmidt MW,
    Trent SM, et al. Halsted’s “see one, do one, and teach one” versus
    Peyton’s four‑step approach: A randomized trial for training of
    laparoscopic suturing and knot tying. J Surg Educ 2018;75:510‑5.
    9. Krautter M, Dittrich R, Safi A, Krautter J, Maatouk I, Moeltner A,
    et al. Peyton’s four‑step approach: Differential effects of single
    instructional steps on procedural and memory performance – A
    clarification study. Adv Med Educ Pract 2015;6:399‑406.
    10. Krautter M, Weyrich P, Schultz JH, Buss SJ, Maatouk I, Jünger
    J, et al. Effects of Peyton’s four‑step approach on objective
    performance measures in technical skills training: A controlled
    trial. Teach Learn Med 2011;23:244‑50.
    11. Greif R, Egger L, Basciani RM, Lockey A, Vogt A. Emergency skill
    training – A randomized controlled study on the effectiveness of
    the 4‑stage approach compared to traditional clinical teaching.
    Resuscitation 2010;81:1692‑7.
    12. Orde S, Celenza A, Pinder M. A randomised trial comparing a
    4‑stage to 2‑stage teaching technique for laryngeal mask insertion.
    Resuscitation 2010;81:1687‑91.
    13. Bullock I. Skill acquisition in resuscitation. Resuscitation
    2000;45:139‑43.
    14. Jenko M, Frangez M, Manohin A. Four‑stage teaching technique
    and chest compression performance of medical students
    compared to conventional technique. Croat Med J 2012;53:486‑95.
  2. 15. Nikendei C, Huber J, Stiepak J, Huhn D, Lauter J, Herzog W,
    et al. Modification of Peyton’s four‑step approach for small group
    teaching – A descriptive study. BMC Med Educ 2014;14:68.
    16. Münster T, Stosch C, Hindrichs N, Franklin J, Matthes J. Peyton’s
    4‑Steps‑Approach in comparison: Medium‑term effects on
    learning external chest compression – A pilot study. GMS J Med
    Educ 2016;33:Doc60.
    17. Awad SA, Mohamed MH. Effectiveness of Peyton’s four‑step
    approach on nursing students’ performance in skill‑lab training.
    J Nurs Educ Practice 2019;9:5.
    18. Kasper RW, Elliott JC, Giesbrecht B. Multiple measures of visual
    attention predict novice motor skill performance when attention
    is focused externally. Hum Mov Sci 2012;31:1161‑74.
    19. Kishore TA, Beddingfield R, Holden T, Shen Y, Reihsen T,
    Sweet RM. Task deconstruction facilitates acquisition of
    transurethral resection of prostate skills on a virtual reality trainer.
    J Endourol 2009;23:665‑8.
    20. Moran A, Guillot A, Macintyre T, Collet C. Re‑imagining motor
    imagery: Building bridges between cognitive neuroscience and
    sport psychology. Br J Psychol 2012;103:224‑47.
    21. Duran D. Learning‑by‑teaching. Evidence and implications
    as a pedagogical mechanism. Innovat Educ Teach Int
    2017;54:476‑84.
    22. Ten Cate O, Durning S. Peer teaching in medical education:
    Twelve reasons to move from theory to practice. Med Teach
    2007;29:591‑9.
    23. Hall S, Harrison CH, Stephens J, Andrade MG, Seaby EG,
    Parton W, et al. The benefits of being a near‑peer teacher. Clin
    Teach 2018;15:403‑7.
    24. Jones RW. Learning and teaching in small groups: Characteristics,
    benefits, problems and approaches. Anaesth Intensive Care
    2007;35:587‑92