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J Surg Educ. 2017 Aug 23. pii: S1931-7204(17)30044-2. doi: 10.1016/j.jsurg.2017.08.002. [Epub ahead of print]

Avoiding Surgical Skill Decay: A Systematic Review on the Spacing of Training Sessions.

Author information

1
Center for Education Development and Research in Health Professions (CEDAR), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: d.cecilio.fernandes@umcg.nl.
2
Institute of Artificial Intelligence and Cognitive Engineering, University of Groningen, Groningen, The Netherlands.
3
Center for Education Development and Research in Health Professions (CEDAR), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
4
Center for Education Development and Research in Health Professions (CEDAR), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Abstract

OBJECTIVE:

Spreading training sessions over time instead of training in just 1 session leads to an improvement of long-term retention for factual knowledge. However, it is not clear whether this would also apply to surgical skills. Thus, we performed a systematic review to find out whether spacing training sessions would also improve long-term retention of surgical skills.

DESIGN:

We searched the Medline, PsycINFO, Embase, Eric, and Web of Science online databases. We only included articles that were randomized trials with a sample of medical trainees acquiring surgical motor skills in which the spacing effect was reported. The quality and bias of the articles were assessed using the Cochrane Collaboration's risk of bias assessment tool.

RESULTS:

With respect to the spacing effect, 1955 articles were retrieved. After removing duplicates and articles that did not meet the inclusion criteria, 11 articles remained. The overall quality of the experiments was "moderate." Trainees in the spaced condition scored higher in a retention test than students in the massed condition.

CONCLUSIONS:

Our systematic review showed evidence that spacing training sessions improves long-term surgical skills retention when compared to massed practice. However, the optimal gap between the re-study sessions is unclear.

KEYWORDS:

Medical Knowledge; Practice-Based Learning and Improvement; distributed practice; long-term retention; medical education; simulation training; spacing effect; surgical skills

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