The Effect of Halsted and Peyton Teaching Approaches on Nursing Students

Summary

Intramuscular (IM) injection is a fundamental nursing skill that requires accurate anatomical knowledge, correct technique, and safe practice. The ventrogluteal site is currently recommended in clinical guidelines as the safest area for IM injections because it is far from major nerves and blood vessels and allows effective medication absorption. However, identifying the correct anatomical landmarks and performing the procedure accurately can be challenging for nursing students, particularly during early skills training.

Different teaching approaches are used in nursing education to support the acquisition of psychomotor skills. The traditional Halsted approach ("see one, do one") is widely used because it is time-efficient, but it may not provide sufficient structure for learning complex, multi-step procedures. In contrast, Peyton's four-step teaching approach offers a structured and interactive method that includes demonstration, explanation, learner-guided repetition, and independent performance. This approach is designed to enhance understanding, skill retention, and active participation in the learning process.

The aim of this randomized controlled trial is to compare the effects of the Halsted teaching approach and Peyton's four-step teaching approach on nursing students' knowledge, skill performance, and self-regulated learning related to ventrogluteal injection administration. The study is conducted with first-year nursing students enrolled in the Fundamentals of Nursing course at a university in Türkiye during the 2025-2026 academic year.

A total of 120 nursing students are randomly assigned to either the intervention group or the control group. All students receive the same theoretical instruction and access to standardized instructional videos before laboratory practice. The control group is taught ventrogluteal injection using the traditional Halsted approach, while the intervention group receives training based on Peyton's four-step teaching method. Skill performance is assessed using an objective structured clinical examination (OSCE) with a standardized skill checklist. Knowledge levels are measured using a validated multiple-choice test, and self-regulated learning is evaluated using a reliable and validated self-regulated learning scale for clinical nursing practice.

The results of this study are expected to provide evidence on whether a structured teaching approach improves learning outcomes in nursing skills education. Findings may contribute to the development of more effective educational strategies for teaching high-risk and technically demanding nursing procedures, ultimately supporting patient safety and clinical competence in future nurses.

Conditions

• Nursing Skills Education

Interventions

BEHAVIORAL

Halsted Teaching Method

A traditional educational intervention based on the Halsted teaching method ("see one, do one"), in which students observe the ventrogluteal intramuscular injection procedure and then perform it individually during laboratory practice.

BEHAVIORAL

Peyton Four-Step Teaching Approach

A structured educational intervention based on Peyton's four-step teaching approach, including silent demonstration, demonstration with explanation, learner-guided demonstration, and independent performance of ventrogluteal intramuscular injection in a laboratory setting.

Sponsors & Collaborators

• Çankırı Karatekin University

  collaborator OTHER

• Gözde ÖZARAS ÖZ

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-02-28

Primary Completion

2026-03-31

Completion

2026-04-30