Objective To explore the application of modified Peyton′s four-step teaching in the basic skills training for pediatric resident physicians. Methods Experimental control methods was used. A total of 83 pediatric first-year residents who received standardized training at Shenzhen Children′s Hospital were selected as the research subjects, among whom 41 residents in 2022 were selected as the experimental group using modified Peyton′s four-step teaching, whereas 42 residents in 2021 were selected as the control group using traditional simulation teaching methods. The teaching effectiveness was evaluated through the theoretical knowledge and skill operation assessment scores of two groups, the pass rate of the first licensed physician qualification exam, direct observation of procedural skills one year after training, and questionnaire survey results. Student t-test and chi square test were used to analyze relevant data. Results There was no significant difference between the two groups in the scores of knowledge tests [(82.22±4.60) vs. (81.81±5.31), P=0.712]. The overall performance of the experimental group in skill operation assessment, passing rate of the first licensed physician qualification exam, and direct observation of procedural skills after one year of training were higher than those of the control group [(88.27±4.97) vs. (81.88±3.99), 100.0%(41/41) vs. 85.7%(36/42), (7.73±1.00) vs. (6.64±1.19)]; satisfaction scores of resident physicians in the experimental group were higher than those in the control group [(4.71±0.46) vs. (4.24±0.73)], and the above differences were statistically significant (all P<0.05). Conclusions The modified Peyton′s four-step approach is helpful to the immediate acquisition and long-term retention of the basic clinical skills for pediatric resident physicians, and improve the teaching effectiveness and satisfaction.