The Effect of Halsted and Peyton Teaching Approaches on Nursing Students

NCT07418697 | Not Yet Recruiting

• 1 other identifier: ARCS-ER-MED-2026-A
• Study Type: interventional
• Target: 110
• Locations: 0 countries
• Sites: N/A

Brief 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

Keywords

nursşng education; Ventrogluteal injection; Intramuscular injection; Psychomotor skill training; Peyton four-step approach; Self-regulated learning

Outcome Measures

Primary Outcomes (1)

• Ventrogluteal Injection Skill Performance

  Skill performance in ventrogluteal intramuscular injection administration is assessed using a structured Ventrogluteal Injection Skill Checklist during an Objective Structured Clinical Examination (OSCE). The checklist consists of 33 items evaluating correct performance of each procedural step. Each item is scored as 0 (incorrect/not performed) or 1 (correct), and total scores are converted to a 0-100 scale. Higher scores indicate better skill performance.

  Immediately after completion of the laboratory training session

Study Arms (2)

Peyton Four-Step Teaching Approach

EXPERIMENTAL

Participants in this arm receive training in ventrogluteal intramuscular injection using Peyton's four-step teaching approach, including demonstration, explanation, learner-guided demonstration, and independent performance during laboratory practice.

Behavioral: Peyton Four-Step Teaching Approach

Halsted Teaching Method

ACTIVE COMPARATOR

Participants in this arm receive training in ventrogluteal intramuscular injection using the traditional Halsted teaching method ("see one, do one") during laboratory practice.

Behavioral: Halsted Teaching Method

Interventions

Peyton Four-Step Teaching Approach BEHAVIORAL

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.

Peyton Four-Step Teaching Approach

Halsted Teaching Method BEHAVIORAL

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.

Halsted Teaching Method

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• First-year undergraduate nursing students
• Enrolled in the Fundamentals of Nursing course for the first time
• Have viewed the online instructional videos related to ventrogluteal intramuscular injection before laboratory practice
• Agree to participate voluntarily
• Provide written informed consent
• Attend all scheduled theoretical and laboratory training sessions

You may not qualify if:

• Graduated from a health vocational high school
• Previously received formal education or training on intramuscular injection techniques
• Do not attend theoretical or laboratory sessions related to the study
• Do not complete the data collection tools
• Withdraw from the study at any stage

Sponsors & Collaborators

• Gözde ÖZARAS ÖZ: lead
• Çankırı Karatekin University: collaborator

Central Study Contacts

Gözde ÖZARAS ÖZ, PhD

CONTACT

+905323495280; gozdeozaras@karatekin.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor of Nursing

Model Details: This study uses a parallel-group randomized controlled design. Eligible nursing students are randomly assigned to either an intervention group receiving training based on Peyton's four-step teaching approach or a control group receiving training based on the traditional Halsted teaching method. Both groups receive the same theoretical instruction prior to laboratory practice, and outcomes are assessed after the intervention.

Study Record Dates

• First Submitted: February 9, 2026
• First Posted: February 18, 2026
• Study Start: February 1, 2026
• Primary Completion: March 1, 2026
• Study Completion: April 1, 2026
• Last Updated: February 18, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share