title: Interval vs massed training: how best do we teach surgery?
abstract: OBJECTIVE
  To compare 2 different training paradigms, massed vs interval training, when novice students learn a surgical procedure, myringotomy with ventilation tube insertion, on a validated surgical simulator.
  
  
  METHODS
  Medical students were randomized into 2 training groups: the interval group (n = 19) was trained to perform the procedure in 5 trials/d over 3 days, and the massed group (n = 21) was trained to perform the procedure in 15 trials all in 1 session. One week later, all students were tested in 5 additional final trials. Pre- and posttest surveys were administered.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Forty medical students: 19 students in the interval group were compared with 21 students in the massed group. Time to complete the procedure and number and type of error made were recorded and compared between groups. Pre- and poststudy surveys examined confidence levels working under a microscope and with the procedure.
  
  
  RESULTS
  Students in both groups had a significant decrease in time between practice and final trials. In the final 5 trials, there was no difference in average time to complete the procedure between the massed and interval training groups. No difference was observed in the number of errors committed per trial between initial and final trials (both groups) or between massed and interval training groups. The students' confidence levels significantly increased across the trials, regardless of group.
  
  
  CONCLUSIONS
  Surgical training improves proficiency, but method of training had little impact on proficiency in performing a simulated surgical procedure in this setting.
authors.affiliation: Departments of Otolaryngology-Head & Neck Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
authors.forename: Bradley W
authors.initials: BW
authors.lastname: Kesser
authors.forename: Matthew
authors.initials: M
authors.lastname: Hallman
authors.forename: Loren
authors.initials: L
authors.lastname: Murphy
authors.forename: Maggie
authors.initials: M
authors.lastname: Tillar
authors.forename: Meg
authors.initials: M
authors.lastname: Keeley
authors.forename: Shayn
authors.initials: S
authors.lastname: Peirce
mesh_terms: D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D013506:Otologic Surgical Procedures / Q000193:education*; D013663:Teaching / Q000379:methods; D014432:Tympanic Membrane / Q000601:surgery; D055815:Young Adult
keywords: graduate medical education; myringotomy; resident teaching; simulation; ventilation tube