Combining Peyton’s four-step approach and Gagne’s instructional model in teaching slit-lamp examination

Developing skills in performing basic slit-lamp biomicroscopy is an important element of the ophthalmology undergraduate curriculum. As a doctor working in an ophthalmology department, I often provide slit-lamp teaching for medical students. This paper describes a lesson plan for this technique using Gagne's nine events of instruction. The presented lesson plan is a combination of Gagne's nine events of instruction and Peyton's four-step approach. Gagne's nine events of instruction correlate with and address the mental conditions of learning when adult learners are presented with various stimuli. Peyton's four-step approach is a model for teaching practical skills that consists of demonstration, deconstruction, explanation, and performance. This article describes a slit-lamp biomicroscopy teaching session using Gagne's nine events of instruction. Each step is carefully elaborated with relevant activities to suit learners with various learning styles. Peyton's approach is used to teach the actual skill. This lesson plan is particularly relevant for tutors designing slit-lamp biomicroscopy teaching for undergraduate students, foundation doctors, general practitioners and emergency department staff. Ultimately, this lesson plan also serves as a model that is applicable for acquiring many other practical skills. The flexible adoption of Gagne's nine events of instruction in combination with other teaching models helps in the planning of effective teaching sessions.