FLS skill acquisition: a comparison of blocked vs interleaved practice

Area of Science:

• Surgical Education
• Medical Simulation
• Skill Acquisition

Background:

• Fundamentals of Laparoscopic Surgery (FLS) certification is a requirement for general surgery residents.
• Current FLS training recommendations favor blocked practice, focusing on one task until proficiency.
• Learning theories suggest interleaved practice may yield superior skill development and retention.

Purpose of the Study:

• To compare the effectiveness of interleaved practice versus blocked practice for learning FLS skills.
• To evaluate skill retention of FLS tasks after a 4-week interval.

Main Methods:

• General surgery residents were randomized into either a blocked or interleaved practice group.
• Participants completed 20 trials of four FLS tasks (peg transfer, pattern cut, suture).
• Performance was assessed immediately after practice and again after a 4-week follow-up period.

Main Results:

• Both practice methods improved performance over time.
• The interleaved practice group demonstrated significantly better performance on the peg transfer task.
• Trends favored interleaved practice for other tasks, with substantial differences noted at immediate and delayed testing.

Conclusions:

• Interleaved practice shows potential advantages over blocked practice for developing and retaining FLS skills.
• The findings suggest a need to reconsider traditional FLS training methods.
• Further research is encouraged to validate the benefits of interleaved practice in surgical education.