As a result of technological and scientific developments, various educational methods are used worldwide and their effectiveness is being researched in different studies. Since skills training affects future performance, various methods have been defined in this area. Among these is the step-by-step approach, first introduced by Walker and Peyton in 1998 (Viswanath et al., 2025, Cenaj et al., 2025).

Laboratory applications hold a significant place in teaching many skills specific to nursing. Students have the opportunity to practice and learn repeatedly on mannequins in a safe environment where errors can be tolerated, through laboratory skill training (Awad and Mohamed, 2019). One of the traditional learning techniques in nursing education, the 'See One, Do One' technique, was introduced by Halsted in 1904 and has been adopted in nursing education (Le et al., 2022, Romero et al., 2018). The model generally consists of two steps, which are schematized as follows.

In addition to the positive characteristics of the method, there are also limitations. In the Halsted method, the student observes the skill once and then applies it. Therefore, the student may experience difficulties in fully comprehending the skill and in achieving long-term learning (Giacomino et al., 2020, Gradl-Dietsch et al., 2019). Although the model has been used for many years in various fields, it does not fully involve active learning in adult education and especially in the teaching of complex skills, there is a potential risk to patient safety due to the possibility that the skill may not be fully and permanently learned (Seifert et al., 2020, Varghese and Abraham, 2024). Apart from this classical method used in nursing education for skill teaching, another method is the "Peyton’s Four-Step Teaching Method," proposed by Walker and Peyton (1998). The method generally consists of four stages and these steps are applied sequentially in teaching skills. These steps demonstrate the skill to the student, explain the skill, allow the student to explain the skill and finally, have the student perform the skill. This method has been widely used and accepted in health-related disciplines and laboratory skill teaching (Mohammed et al., 2019; Ng, 2014; Nourkami-Tutdibi et al., 2020; Leitmann, Reinert, and Weise, 2020) (Fig. 1).

The Peyton model has been widely accepted in many countries, particularly known for its positive impact on students’ learning of complex skills. Although the model requires more learning time compared with the traditional method, it significantly contributes to the long-term acquisition of skills (Pivaç et al., 2021; Nikendei et al., 2014; Heriwardito et al., 2023). There is limited evidence supporting the superiority of Peyton's approach over other teaching methods. Although it has been adopted in nursing education, it is emphasized that more research is needed to determine optimal nursing skill training practices. It is important for the Peyton model, a modern and active teaching method, to be included in the literature of our country and to contribute to nursing education. This study is planned as a comparison of the effects of the Halsted and Peyton approaches on objective performance, self-regulated learning and satisfaction in first-year nursing students during laboratory practice courses.

This study aimed to experimentally evaluate the effectiveness of Peyton’s four-step teaching method compared with the traditional Halsted method in teaching urinary catheterization skills to nursing students.

H1

The four-step Peyton teaching model has a greater effect on the average knowledge scores (70 and above) in urinary catheterization skill training in nursing than the Halsted teaching model.

H2

The four-step Peyton teaching model has a greater effect on satisfaction in urinary catheterization skill training (5 above) in nursing than the Halsted teaching model.

H3

The four-step Peyton teaching model has a greater effect on the skill scores (70 and above) in urinary catheterization in nursing than the Halsted teaching model.