Teaching Surgical Skills: What Kind of Practice Makes Perfect?

Thirty-eight junior surgical residents, randomly assigned to either massed (1 day) or distributed (weekly) practice regimens, were taught a new skill (microvascular anastomosis). Each group spent the same amount of time in practice. Performance was assessed pretraining, immediately post-training, and 1 month post-training. The ultimate test of anastomotic skill was assessed with a transfer test to a live, anesthetized rat. Previously validated computer-based and expert-based outcome measures were used. In addition, clinically relevant outcomes were assessed.

Both groups showed immediate improvement in performance, but the distributed group performed significantly better on the retention test in most outcome measures (time, number of hand movements, and expert global ratings; all P values