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VOLUME 10 , ISSUE 1--4 ( January-December, 2024 ) > List of Articles


A Comparative Study to Assess the Effectiveness of Modified Peyton's and Halstead's Approach in Teaching Basic Airway Management Skills to Undergraduate Medical Students in Skills Lab

Sathis C Sundararaju, Raja Poovathai, Sushmitha Rishabh, Soundarya Anbarasan, Kadirvelu S Ramalingam

Keywords : Basic airway management, Halstead's, Indian Medical Graduate, Modified Peyton's, Objective structured clinical examination, Skills, Skills lab, Student-to-teacher ratio, Teaching method

DOI: 10.5005/jp-journals-10045-00251

License: CC BY-NC 4.0

Published Online: 10-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Basic airway management is a lifesaving skill that needs to be mastered by undergraduate medical students. Training of procedural skills in the skills labs is found to be effective. Various skills teaching methods like Halstead's (see one, do one), Peyton's 4-step (student-to-teacher ratio of 1:1), and modified Peyton—for small group teaching with varying student-to-teacher ratios ranging from 3:1 to 13:1 were reported in literature, with few studies showing Peyton method to be more effective than standard teaching. Whereas, few other studies show only minor differences between Peyton's and Halstead's. Aim: This study was conducted to compare the effectiveness of modified Peyton's and Halstead's approaches in teaching basic airway management skills and to know about the students’ perception of modified Peyton's as a skills training method. Materials and methods: A study involving 60 undergraduate medical students was conducted in a skills lab using manikins, with a student-to-teacher ratio of 10:1. Overall, for skill 1 (airway maneuvers and use of airway adjuncts), group I (n = 30) students received training by modified Peyton's and group II (n = 30) students by Halstead's. For skill 2 (bag and mask ventilation), a crossover of groups was done. Group I (n = 30) received training from Halstead's, and group II (n = 30) from modified Peyton's. Students’ performance of both skills was assessed using an objective structured clinical examination (OSCE) 1 week after skills teaching. Students’ perceptions about modified Peyton's were obtained using a questionnaire on a 6-point Likert scale. Results: Objective structured clinical examination scores of skill 1 (Airway maneuvers and use of airway adjuncts) in group I (n = 30) were (17.63 ± 0.89) and in group II (n = 30) were (15.67 ± 1.42); (p < 0.001). OSCE scores of skill 2 (bag and mask ventilation) in group I (n = 30) were (15.10 ± 1.27) and in group II (n = 30) were (17.20 ± 0.96); (p < 0.001). Modified Peyton's was well accepted by students as a skills teaching method except for too many repeated observations of the procedure. Conclusion: Modified Peyton's was found to be an effective skills teaching method than Halstead's for teaching basic airway management skills. However, OSCE should be conducted at different time intervals, in order to assess the long-term retention of skills and to assess the transferability of learned skills to the bedside.

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