Simulation‑Based Intravenous Cannulation Training Using Peyton’s Four‑Step Method in Undergraduate Nursing Students: A Pilot Quasi‑Experimental Study

Yazdani, Faridokht; Toghian Chaharsoughi, Narges

Volume 23, Issue 3 (7-2026) | Back to browse issues page

Ethics code: IR.IAU.NAJAFABAD.REC.1402.224

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Yazdani F, Toghian Chaharsoughi N. Simulation‑Based Intravenous Cannulation Training Using Peyton’s Four‑Step Method in Undergraduate Nursing Students: A Pilot Quasi‑Experimental Study. Mod Care J 2026; 23 (3)
URL: http://mcj.bums.ac.ir/article-1-622-en.html

Simulation‑Based Intravenous Cannulation Training Using Peyton’s Four‑Step Method in Undergraduate Nursing Students: A Pilot Quasi‑Experimental Study

Faridokht Yazdani ^*¹

, Narges Toghian Chaharsoughi²

1- Department of Nursing, Na.C., Islamic Azad University, Najafabad, Iran & Nursing and Midwifery Sciences Development Research Center, Na.C., Islamic Azad University, Najafabad, Iran , faridokht.yazdani@iau.ac.ir
2- Department of Nursing, Na.C., Islamic Azad University, Najafabad, Iran & Nursing and Midwifery Sciences Development Research Center, Na.C., Islamic Azad University, Najafabad, Iran

Abstract: (80 Views)

Introduction: Peripheral intravenous (IV) cannulation is a fundamental yet challenging skill for undergraduate nursing students. Simulation‑based education provides a safe and controlled environment for practicing invasive procedures; however, its effectiveness depends on the instructional design used. Peyton's four‑step method offers a structured, learner‑centered approach that may enhance procedural competence.
Objectives: This study aimed to evaluate the effectiveness of simulation‑based IV cannulation training using Peyton's four‑step method on procedural learning outcomes among novice nursing students. Secondary outcomes included procedural efficiency (time and number of attempts), self‑efficacy, and learner acceptance of the instructional method.
Methods: This pilot quasi-experimental study enrolled 16 first-semester nursing students who were randomly assigned to an intervention group (n = 8) using Peyton's four-step method (180-min simulation) or a control group (n = 7) receiving traditional instruction. The control group's traditional instruction encompassed standard didactic lectures and instructor-led demonstrations with "observe and do" approaches. Post-intervention performances were video‑recorded and assessed by blinded evaluators using a validated 26‑item checklist. Outcome measures included procedural time, attempts, and general/IV cannulation self-efficacy. Data were analyzed using appropriate statistical tests (p < 0.05).
Results: Students trained with Peyton's four-step method achieved significantly higher procedural learning scores than the control group (intervention: 16.79 ± 6.27 vs. control: 10.45 ± 2.21; p = 0.002; d = 1.32). While the intervention group showed trends towards shorter cannulation times (6.50 ± 0.53 vs. 7.00 ± 0.58 minutes) and fewer attempts (1.13 ± 0.35 vs. 1.43 ± 0.53), these differences were not statistically significant. Learner acceptance of the instructional method was significantly higher in the intervention group (48.57 ± 3.15 vs. 43.28 ± 5.58; p = 0.039; d = 1.05), reflecting strong learner approval of the structured approach.
Conclusion: This pilot study suggests that Peyton's four-step method may be a well-accepted and effective instructional strategy for teaching IV cannulation in simulation settings, with positive trends in procedural learning. However, due to the very small sample size, no definitive conclusions can be drawn regarding the overall effectiveness or generalizability of the findings. Further research with larger sample sizes is recommended to confirm these preliminary results.