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Research Article: The effect of a modified Peyton's four-step teaching method on orthokeratology skills: an experimental study

Date Published: 2026-05-11

Abstract:
This study aimed to evaluate the effectiveness of a modified Peyton's four-step method in teaching orthokeratology skills. A total of 60 fourth- and fifth-year optometry students undertaking internships at the Optometry Center of the Second Affiliated Hospital of Anhui Medical University in December 2025 were enrolled. The students were randomly assigned to an experimental group or a control group, with 30 students in each group. The experimental group received training in basic orthokeratology skills using the modified Peyton's four-step teaching method, whereas the control group was trained using the traditional “See One, Do One” approach. The total training duration was four credit hours. One week after completion of the training, skill-based operational assessments and teaching satisfaction questionnaires were administered to both groups. Statistical analyses were conducted using the t -test and the chi-square test. For lens cleaning, lens wearing, trial wear evaluation, and total scores, the experimental group achieved significantly higher scores than the control group ( P < 0.05). No statistically significant difference was observed between the two groups in scores for determining lens parameters ( P > 0.05). The satisfaction questionnaire showed that students in the experimental group reported significantly higher scores for teaching arrangement, teaching methods, interactive feedback and participation compared with the control group ( P < 0.05). There were no statistically significant differences between the two groups in scores for assessment methods or overall satisfaction with teaching ( P > 0.05). The modified Peyton's four-step teaching method demonstrated favorable outcomes in training basic orthokeratology skills and achieved high trainee satisfaction, indicating that it is worthy of wider adoption.

Introduction:
Orthokeratology is an important component of myopia prevention and control strategies for adolescents and represents a fundamental skill that optometry students are required to master. However, teaching in this area currently faces several challenges, including extensive course content, limited class hours, numerous operational steps, and difficulties in memorization. The traditional approach to teaching orthokeratology skills is predominantly the “See One, Do One” method, first proposed by Dr Halsted in 1904.…

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