{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T23:48:12Z","timestamp":1771976892935,"version":"3.50.1"},"reference-count":24,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University Research Project of Anhui province, Major Project","award":["2023AH040373"],"award-info":[{"award-number":["2023AH040373"]}]},{"name":"Anhui Province Clinical Medical Research Transformation Project","award":["202304295107020016"],"award-info":[{"award-number":["202304295107020016"]}]},{"name":"Anhui Medical University Quality Engineering Project, Clinical Teaching Case Resource Construction Project","award":["2024xjxm46"],"award-info":[{"award-number":["2024xjxm46"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>To investigate whether combining the flipped classroom approach with Peyton\u2019s four-step method can enhance teaching effectiveness in ultrasound (US) zoning of the thyroid and cervical lymph nodes for standardized residency training.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 66 resident training students were randomly divided into a control group and an observation group. The control group received traditional teaching methods, including \u201csee one, do one\u201d learning, lecture-based learning (LBL), and case-based learning (CBL). The observation group was taught using Peyton\u2019s four-step teaching method, the flipped classroom approach, and CBL. Assessments were conducted through skill operation and clinical case analysis. A questionnaire survey was used to evaluate student satisfaction. Assessment scores and questionnaire ratings between the two teaching methods were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>1) Assessment results demonstrated higher scores in skill operation and clinical case analysis for the observation group compared to the control group [(87.64 \u00b1 3.72) <jats:italic>vs<\/jats:italic>. (80.48 \u00b1 5.92) points, (87.94 \u00b1 4.46) <jats:italic>vs<\/jats:italic>. (82.85 \u00b1 4.24) points]. 2) The questionnaire survey indicated that resident trainees taught using Peyton\u2019s four-step method showed greater improvement in learning interest [(4.61 \u00b1 0.57) <jats:italic>vs<\/jats:italic>. (3.70 \u00b1 0.85) points] and experienced reduced exam pressure compared to the control group [(4.52 \u00b1 0.62) <jats:italic>vs<\/jats:italic>. (3.21 \u00b1 0.70) points]. These differences were statistically significant (<jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Peyton\u2019s four-step approach combined with the flipped classroom method improved resident training students\u2019 scores in skill operation and clinical case analysis for ultrasound zoning of the thyroid and cervical lymph nodes. It also stimulated learning interest and alleviated exam pressure, making it an effective teaching method for enhancing standardized US training outcomes in resident education.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.18633","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T08:48:41Z","timestamp":1734511721000},"page":"e18633","source":"Crossref","is-referenced-by-count":4,"title":["Flipped classroom-based application of Peyton\u2019s four-step approach in standardized training of ultrasound residents for thyroid and cervical lymph node zoning"],"prefix":"10.7717","volume":"12","author":[{"given":"Jiajia","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Ultrasound Medicine, the Second Affiliated Hospital of Anhui Medical University, Hefei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunyun","family":"Zhan","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Medicine, the 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