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Virtual reality simulators have shown to be valid and useful tools for training psychomotor skills for endoscopic surgery. Discussion arises how to integrate these simulators into the surgical training curriculum. Distributed training is referred to as short training periods, with rest periods in between. Massed training is training in continuous and longer training blocks. This study investigates the difference between distributed and massed training on the initial development and retention of psychomotor skills on a virtual reality simulator. Four groups of eight medical students lacking any experience in endoscopic training were created. Two groups trained in a distributed fashion, one group trained in a massed fashion and the last group not at all (control group). All performed a post-test immediately after finishing their training schedule. Two months after this test a second post- test was performed. The one-way analysis of variance (ANOVA) with Post-Hoc test Tukey-Bonferoni was used to determine differences in mean scores between the four groups, whereas a pvalue ≤0.05 was considered to be statistically significant. Distributed training resulted in higher scores and a better retention of relevant psychomotor skills. Distributed as well as massed training resulted in better scores and retention of skills than no training at all. Our study clearly shows that distributed training yields better results in psychomotor endoscopic skills. Therefore, in order to train as efficient as possible, training programs should be (re)-programmed accordingly

Distributed versus Massed Training: Efficiency of Training Psychomotor Skills