ID: 85 (Conflict of Interest: K)

Einfluss des "spaced learning"-Konzeptes auf die langfristige laparoskopische Performance - eine Pilotstudie

M.Boettcher, J.Boettcher, L.Klippgen, S. Mietzsch, K.Reinshagen
Universitätsklinikum Hamburg-Eppendorf, Hamburg


Spaced, hypercondensed learning has been shown to be extraordinary effective in various areas like traditional knowledge or motor skill acquisition like laparoscopic suturing. Some people believe that frequent pausing instead of active pauses (which are an integral part of the spaced learning concept to reduce interference) are sufficient. To evaluate the long-term effects of the concept on complex motos skills like laparoscopic suturing was the aim of the study.

Material und Methoden

To evaluate the effectiveness of spaced learning, subjects were trained either trained for 4 hours in a hands-on course to perform 4 surgeon's square knots on a bowel model. After one year the same subjects were asked to perform the same procedure in much more complex setting (esophageal atresia with tracheoesophageal fistula model). All subjects were medical students and novice in open and laparoscopic suturing. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality (Muresan score) and laparoscopic performance (Munz checklist) were assessed. Moreover, motivation was accessed using Questionnaire on Current Motivation.


Twenty students were included in the study; after simple randomization, ten were trained using the classic “spaced learning” concept and ten were trained with similar interuptions but passive pauses. After one year the performance was reassessed in a more complex model (to test transferability and long-term acquisition). Both groups had comparable baseline characteristics and improved after training significantly regarding all aspects assessed in this study. Subjects that trained via classic "spaced learning" were superior in terms of suture performance, knot quality and suture strength. 


The spaced learning concept is very suitable for complex motor skill acquisition like laparoscopic suturing and knot tying. It significantly improves long-term laparoscopic performance and knot quality. Thus, we recommend to incorporate spaced learning with active pauses into training courses and surgical programs.