Teaching Procedural Skills Following Peyton’s Four-Step Method: Bedside Teaching in Hospital Wards

Abstract

Bedside teaching in clinical education is undoubtedly relevant as it offers organized learning opportunities that enhance knowledge, attitudes, and skills among the learners. Acquisition of procedural skills is an important component of medical education across the spectrum of medical and surgical training. However, teaching procedural skills to beginners is a multifaceted challenge, as it requires the integration of cognitive and motor skills. It is also essential that these skills are retained, enabling today’s learners to effectively apply them at patients’ bedsides in hospitals or private practice, even many years after they are initially taught. Several well-established methods are used for sequential teaching of bedside procedures. Among those, Peyton's four-step method offers step-wise clinical teaching (for procedural skills) to learners; these four steps are: 1) demonstration; 2) deconstruction; 3) comprehension; and 4) performance and integration. This four-step approach has shown decisive advantages over traditional instruction. This review paper aims to see how and to what extent Peyton’s four-step method supports teaching procedural skills to undergraduate medical students as well as postgraduate residents focusing on bedside teaching in the hospital wards.  

CBMJ 2026 July: Vol. 15 No. 02 P:423-429