🔍 Key Findings
- Spaced instruction (SI) improved immediate performance on the first learned skill compared to massed instruction (MI) in both LSU and LMU cohorts.
- Cognitive load was higher in MI students at LMU, particularly in physical demand, effort, and frustration, while LSU showed no significant cognitive load differences.
- Skill performance differences disappeared after 2 weeks of supervised practice, regardless of instructional format.
- Time to complete skills improved over time, but this did not always correlate with improved checklist or global rating scores.
- Intrinsic cognitive load increased when teaching more complex or related surgical tasks in the same session.
- Initial skill complexity and prior exposure may influence effectiveness of spaced vs massed instruction.
- Supervised practice sessions are critical to eliminate initial skill disparities between instructional methods.
- Massed instruction may still be acceptable if followed by scheduled practice opportunities.
