Qinbo Wang,1â 3,* Zongyan Li,1,* Xiaojia Huang,1 Xiaoyan Fu,1 Qian Li,1 Haiyan Li1,3 1Department of Breast Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Peopleâs Republic of China; 2Department of Pharmacy, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Peopleâs Republic of China; 3Department of Graceland Medical Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Haiyan Li, Department of Breast Surgery, the Sixth Affiliated Hospital, Sun Yat-Sen University, 26# Erheng Road, Yuan Village, Tianhe District, Guangzhou, 510655, Peopleâs Republic of China, Email lihy27@mail.sysu.edu.cnPurpose: Traditional standardized training in ultrasound-guided minimally invasive breast surgery (UMIBS) focused on lecture-based learning (LBL) resulted in studentsâ insufficient analysis, limited spatial visual conversion ability, and poor practical application. This study examined the effects of the step-by-step (SBS) method combined with a simulation model in UMIBS education.Subjects and Methods: A total of 84 residents participated in this study. The residents were divided into the SBS group (experience group, n=42) and the LBL group (control group, n=42), and the same teacher taught the two groups to ensure a comparable result. Based on the pork simulation model, two experts evaluated student performance scores, and the total time taken by each student was also counted. The participants were surveyed with 7 questions after the training, and each answer was assigned a score of 1, 2 or 3 to compare the participantsâ satisfaction.Results: The average value of the surgical skills for SBS group were significantly higher than LBS group, which was 82.8± 4.4 and 72.7± 4.0 (t=4.27, P< 0.001), the time spend of neoplasm localization by the experience group was significantly less than the control group, which was 17.9± 1.6 and 20.9± 1.2 secs, (t=1.58, P< 0.001), and there were significant differences in puncture accuracy and excision integrity between the two groups (P< 0.05). In addition, the results of the questionnaire survey showed that learning interest, surgical ability and satisfaction were better in the SBS group than in the LBS group (P< 0.05), and there were no significant differences in clinical thinking and learning pressure between the two groups.Conclusion: The SBS teaching method may help to improve the surgical skills and learning interest, as well as reduce adverse reactions and cultivate clinical thinking of the students in UMIBS training. Future studies could consider multicenter clinical research to further confirm the practicality of this teaching method and reduce the risk of deviation.Keywords: ultrasound, minimally invasive, step by step, lecture-based learning, simulation