title: Increasing efficiency of surgical training: effects of spacing practice on skill acquisition and retention in laparoscopy training.
abstract: OBJECTIVE
  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.
authors.affiliation: Cognitive Psychology Unit, Institute of Psychology, Faculty of Social Sciences, Leiden University, Postbus 9555, 2300 RB, Leiden, The Netherlands, e.n.spruit@fsw.leidenuniv.nl.
authors.forename: Edward N
authors.initials: EN
authors.lastname: Spruit
authors.forename: Guido P H
authors.initials: GP
authors.lastname: Band
authors.forename: Jaap F
authors.initials: JF
authors.lastname: Hamming
mesh_terms: D000293:Adolescent; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D012153:Retention, Psychology; D013663:Teaching / Q000379:methods*; D055815:Young Adult