Using Individual Residents' Learning Trajectories to Better Understand the Impact of Gaps in Practice

Area of Science:

• Medical Education
• Surgical Training
• Learning Curves

Background:

• Optimizing health professional training requires balancing depth and breadth of practice.
• Understanding the impact of skill set changes on training is crucial for curriculum design.

Purpose of the Study:

• To compare surgical performance after prolonged practice versus after training gaps.
• To inform curriculum and assessment design for enhanced training efficiency and care effectiveness.

Main Methods:

• Retrospective analysis of 4,416 operative assessments from an obstetrics and gynecology residency program over 10 years.
• Generation of learning curves to assess performance trajectories and the impact of training gaps.
• Comparison of resident scores after continuous assessment versus after at least two months without assessment.

Main Results:

• Residents performed better during their third consecutive month of assessment (mean=4.40) compared to after a 2-month gap (mean=4.21).
• Peak performance was more strongly correlated with the frequency of training gaps (r=0.50) than with consecutive training months (r=0.25).

Conclusions:

• Individual residents exhibit distinct learning patterns.
• While time away negatively impacts short-term surgical performance, it may enhance long-term learning trajectories.
• Spaced education principles are valuable for designing longitudinal, skills-based training programs.