Evaluation of Performance of Third MBBS Phase II Students in Nasogastric Tube Insertion in Simulation by Peyton's Four-Step Method

ABSTRACT Background: Nasogastric tube (NGT) insertion is an essential clinical skill for medical students, especially in neonatal care, where procedural accuracy is vital. Traditional teaching methods often fail to support adequate skill retention. Peyton's Four-Step Method, a structured teaching approach, has demonstrated effectiveness in clinical skills training but requires further evaluation regarding its impact on immediate performance and skill retention at follow-up. Aim & Objectives: This study aimed to evaluate the effectiveness of Peyton's Four-Step Method in teaching Third MBBS Phase II students the skill of nasogastric tube insertion. Specific objectives included assessing immediate post training performance and retention of skills at a one-month follow-up. Methodology: An educational interventional study was conducted with 50 Third MBBS Phase II students, excluding those with prior experience in neonatal NGT insertion. A structured three-hour training session was delivered to groups of 25 students by two instructors (student to instructor ratio 25:2) using a Neonatal Feeding Tube Insertion Simulator, following Peyton's Four-Step Method (demonstration, deconstruction, comprehension, and performance). Students were permitted to engage in voluntary, self-directed practice on the simulator during the one-month interval preceding the retention assessment, according to their individual needs. Performance was assessed through the Objective Structured Clinical Examination (OSCE) at baseline (pretest), immediately after the training session (post-test 1), and one-month later (post-test 2). Data analysis utilized paired t-tests to compare mean OSCE scores across assessment phases.