Peyton's Four-Step Teaching Approach Improves Students' Technique to Perform a Cranial Drawer Assessment but Does Not Improve Their Ability to Diagnose Cranial Cruciate Ligament Rupture in a Canine Stifle Joint Model.

Peyton's four-step teaching approach (PFSA) has been shown to be beneficial in teaching medical students practical skills for clinical practice. This study evaluated the effectiveness of PFSA in comparison to a standard method (ST) for teaching students to confidently perform the cranial drawer assessment and to identify cranial drawer in a canine stifle joint model that simulated different types of cranial cruciate ligament (CCL) integrity (complete rupture, partial rupture, and intact). Students were randomly allocated into two groups, taught how to perform a cranial drawer test with either PFSA or the ST, and tasked to assess CCL integrity in six models. The assessment was repeated 2 weeks later. Students taught with the PFSA had higher scores for their technique when compared with the ST group (p < .01) for both intact and partial CCL rupture models at the initial assessment. The ability to correctly identify the CCL integrity in the models was not different between the ST and PFSA groups. Student confidence in being able to perform the cranial drawer test improved in both the ST and PFSA groups at the second assessment. While PFSA improved students' technique and their confidence in assessing the CCL integrity, their ability to correctly identify CCL functional integrity in the stifle joint model was not improved. The benefits of using PFSA need to be balanced with the greater time it takes to perform.