gms | German Medical Science

4th Research in Medical Education (RIME) Symposium 2015

19.03-21.03.2015, München

Adapted peer-assisted PEYTON-Method and gradual assessment for sustainability of student’s skill to exercise indirect mirror technique of the Ear-Nose-Throat (ENT) area

Meeting Abstract

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  • corresponding author presenting/speaker Matthaeus Grasl - Medical Universitiy Vienna, Department of Otorhinolaryngology, Vienna, Austria
  • author Michael Hanisch - Medical Universitiy Vienna, Department of Otorhinolaryngology, Vienna, Austria
  • author Karl Kremser - Medical Universitiy Vienna, Department for Medical Education, Vienna, Austria

4th Research in Medical Education (RIME) Symposium 2015. München, 19.-21.03.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP21

doi: 10.3205/15rime36, urn:nbn:de:0183-15rime361

Veröffentlicht: 12. März 2015

© 2015 Grasl et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen. Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden. Lizenz-Angaben siehe



Introduction: Trainees have to reach a certain level of skills competence before they are supposed to use these skills on patients. One way of teaching skills, the Peyton’s Four Step Approach was designed for a 1:1 teacher:student ratio, requiring enormous resources of teachers. The aim of the present study was to develop and evaluate a modified Peyton’s approach for teaching groups of up to 30 students by one teacher. The research question is: is it possible that a single teacher can transfer skills to a group of up to 30 students, making them fit for performing these skills competently on patients. Only significant modifications of Peyton’s four steps together with curricular adaptations can fulfil this requirement.

Methods: In the academic year of 2013/14 at the Medical University of Vienna students of the 5th year have to pass the ENT clinical module within 2½ weeks. The central learning goal is to achieve the competence of the indirect mirror technique and apply it to patients. 275 Students in 12 Groups of 25 to 30 participants were included in the study. Modification of Peyton’s four steps was:

only one teacher,
intensive use of peer-assisted teaching
intensive theoretical knowledge before
ongoing assessment
emphasis on communication with patients.

Results: An initial questionnaire with 18 questions concerning clinical ENT-anatomy showed 16.9 correct answers on average. The peer-assisted learning contributed substantially to the learning process. All students could be transferred to patients contact without hesitation – after repetition and final assessment in a small group of 6 to 7 students.

Discussion: This modified Peyton’s approach to instruct larger groups of students in the indirect mirror technique in the ENT-field has shown to be practicable, well accepted by the students, however is carried out with an enormous demand on the single teacher. Skills require more than performing key tasks. Further research should address the realization of the model to other clinical subjects and skills [1], [2], [3], [4], [5].


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