Impact of Clinical Skills Training Program Using Peyton’s Four-Step Approach on Skill Acquisition by Novice Physical Therapists

This study aims to determine the impact of a training program that utilizes Peyton’s four-step approach on the acquisition of clinical skills by novice physical therapists at a facility in Japan.

Eight novice physical therapists who had graduated from a physical-therapist training school in April 2024 participated in the study. The training was conducted by two physical therapists, each with more than 10 years of teaching experience. The participants were segregated into two groups of four, with each comprising one instructor. The instructors used Peyton’s four-step approach for guidance. The training involved the following exercises: range of motion, muscle strengthening, getting up, standing up, sitting down, and transferring between a wheelchair and bed. Each training session lasted 60 min. To evaluate the participants’ clinical skills before and after training, an objective structured clinical examination (OSCE) for physical and occupational therapists was used. The OSCE for each exercise task included multiple items, and each item was evaluated on a three-point scale. The percentage of perfect OSCE scores was calculated for each participant and task. Statistical tests, i.e., the χ2 test or Wilcoxon signed rank test, were performed depending on normality, with the significance set at p 0.05. All statistical analyses were performed using EZR version 1.68 (Saitama Medical Center, Jichi Medical University, Japan).

Changes in the percentage of perfect OSCE scores pre- and post-training were as follows: 69.7±16.9% to 87.1±9.9% for range-of-motion exercises, 83.8±18.0% to 83.3±13.8% for muscle-strengthening exercises, 79.5±15.9% to 92.0±6.2% for getting-up exercises, 67.5±16.9％ to 81.7±14.9％ for standing/sitting exercises, and 70.8±14.8% to 88.8±6.8% for transfer exercises. Significant differences were indicated for all tasks except for the muscle-strengthening exercises.

Improvement in clinical skills after training suggests that a clinical skills training program using Peyton’s four-step approach is effective for novice physical therapists.

This study is important for the development and enhancement of clinical skills training programs for novice physical therapists.