studies

Spruit (2014). Increasing efficiency of surgical training: effects of spacing practice on skill acquisition and retention in laparoscopy training.

Table of Contents

Full Citation

Spruit, E. N., Band, G. P., & Hamming, J. F. (2014). Increasing efficiency of surgical training: effects of spacing practice on skill acquisition and retention in laparoscopy training. Surgical Endoscopy. https://doi.org/10.1007/s00464-014-3931-x

Abstract

Objectives The goal of this study was to investigate the effects of spaced versus massed practice on skill acquisition and retention in the context of laparoscopic motor skill training. Background Reaching proficiency in performing laparoscopic surgery involves extensive training to acquire the required motor skills. Conventionally, training of such skills occurs during a full day training event utilizing surgical simulators that train specific motor skills pertinent to laparoscopic surgery. An important variable to consider is the optimal schedule for laparoscopic motor training. Methods In this study, two groups of trainees without prior experience were trained on a variety of physical box-trainer tasks on different time-schedules. One group received three 75-min training sessions on a single day (massed condition) and the other received one 75-min training session per week for three consecutive weeks (spaced condition). Short- and long-term retention were assessed 2 weeks and 1 year after the completion of training. Results Outcome measures indicated better performance at the end of training, at a 2-week delayed retention session and at a 1-year retention session for the group that received training on a spaced schedule. This spacing effect was most pronounced for the more difficult laparoscopic training tasks such as intra-corporeal suturing. On average, 21 % of participants in the massed group and 65 % in the spaced group reached proficiency by the end of training. Conclusions Spacing practice of laparoscopic motor skill training will facilitate skill acquisition, short-term and long-term retention, and thus, a more efficient learning process for trainees. Though more challenging in terms of logistics, training courses in medical centers should distribute practice sessions over longer time intervals.

Key Results

Result Name Effect Size Reliability
Spaced vs. Massed: Simple Tasks (Immediate Performance)
Large
Large
High
High
Spaced vs. Massed: Simple Tasks (Long-Term Learning, 2 Weeks)
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Spaced vs. Massed: Simple Tasks (Long-Term Learning, 1 Year)
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Spaced vs. Massed: Complex Tasks (Immediate Performance)
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Spaced vs. Massed: Complex Tasks (Long-Term Learning, 2 Weeks)
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Spaced vs. Massed: Complex Tasks (Long-Term Learning, 1 Year)
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Study Characteristics

Learning Domain Procedural Learning
Study Topic Massed Practice, Spaced Practice
Study Type
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Task Studied
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Subject Type
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Quality Score (%)*
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* Study quality assessed using JBI Systematic Review Checklist.

Reviewer Notes

The training of surgical skills is a common real-world skill investigated in motor learning research. This study looked at whether the benefits of spaced practice — known for many decades to be beneficial for learning — apply to surgical training, because (it claims) most training occurs on a massed practice schedule because it’s easier to organize. This is a good point — massed practice is often associated with “cramming”, but sometimes it’s simply practical. Generally, the results show that once again spaced practice is superior. But what makes this study more interesting is that it breaks down the effect on simple versus complex skills, and the follow-up periods are very long — testing a year after training.

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