The Effect of Halsted and Peyton Teaching Approaches on Nursing Students' Knowledge, Skills, and Self-regulated Learning in Ventrogluteal Injection Administration: A Randomized Controlled Trial.

The acquisition of psychomotor nursing skills is a core component of undergraduate nursing education and plays a critical role in ensuring patient safety and clinical competence. Intramuscular (IM) injection administration is one of the most frequently performed nursing procedures and requires precise anatomical knowledge, correct technique, and adherence to aseptic principles. Among IM injection sites, the ventrogluteal region is recommended by current clinical guidelines as the safest option due to its distance from major nerves and blood vessels, adequate muscle mass, and lower risk of complications. Despite these advantages, ventrogluteal injection is often perceived by nursing students as difficult to learn because it requires accurate identification of anatomical landmarks and coordinated psychomotor performance.

Teaching methods used in nursing skills education may influence how effectively students acquire, retain, and apply complex clinical procedures. The Halsted teaching approach, commonly summarized as "see one, do one," has traditionally been used in skills laboratories because of its simplicity and efficiency. However, this approach may be insufficient for procedures that involve multiple sequential steps and require high levels of cognitive engagement and error awareness. In contrast, Peyton's four-step teaching approach provides a structured framework for skills training that integrates observation, explanation, learner participation, and independent practice. By actively involving students in the learning process, Peyton's approach is thought to enhance deeper understanding, improve psychomotor performance, and support self-regulated learning.

Self-regulated learning is an essential competency for nursing students, particularly in clinical practice settings where learners are expected to plan, monitor, and evaluate their own learning and performance. Educational strategies that promote active participation and structured feedback may contribute to the development of self-regulated learning behaviors. Although previous studies have demonstrated the effectiveness of Peyton's four-step approach in various clinical skills, evidence comparing this approach with the traditional Halsted method specifically for ventrogluteal injection training in nursing education remains limited.

This randomized controlled trial was designed to compare the effects of the Halsted teaching approach and Peyton's four-step teaching approach on nursing students' learning outcomes related to ventrogluteal injection administration. The study focuses on three key domains: cognitive outcomes (knowledge related to ventrogluteal injection), psychomotor outcomes (skill performance assessed through an objective structured clinical examination), and learning process outcomes (self-regulated learning in clinical nursing practice).

The study is conducted in a controlled laboratory setting as part of the Fundamentals of Nursing course. Prior to the laboratory sessions, all participants receive standardized theoretical instruction on intramuscular injections and access to instructional videos prepared by faculty members. This ensures that baseline exposure to theoretical content and visual learning materials is equivalent across groups. Laboratory practice sessions are then conducted using different teaching approaches according to group allocation.