The Curious Role of Spaced Practice and Staggered Retrieval in Learning Engagement

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Tricky microsurgery? Forget a bit before you practice more

Microvascular anastomosis is a mouthful to you and me. It is a challenge even to surgeons.

Microvascular anastomosis (MA) has been described as a surgical technique that requires high skills. It is the fine art of precisely repairing a vessel that is 2 mm or less in diameter, with the help of optical magnification.

Of course, it requires plenty of practice. If you are a surgical resident the best way to master MA would be to practice it every hour of the day, right? Wrong!

Space practice to ace skill

There is no learning without learning engagement. Practice is one of the two pillars of learning engagement. You cannot walk into the operation theater, peer into the microscope, and expect to perform a MA, if you have not had sufficient practice.

No one disputes the importance of practice. However, learning science says you might be better off if that practice is staggered. Better still, mix up the reading and the doing, allowing enough time between sessions. You might forget a bit from one session to the next. That is not a bad thing. In fact, it will apply some surgical glue to the essential knowledge and skills you need to retain.

As the patient who has to undergo the MA, you might be a little wary of a surgeon who learnt by forgetting! Well, research has proved it can be lifesaving.

Distributed learning yields sharper surgeons

This study compared the commonest method of training in continuing medical education (CME), a “single multihour event” with an alternative method, where learning is distributed over several training sessions.

Thirty-eight junior surgical residents were randomly assigned to two groups. Both groups practiced for the same duration. One group followed a massed (one day) regimen while the other practiced in a distributed (weekly) manner. Members of both groups were taught the new skill of MA.

Researchers assessed the performance of all residents before the training, immediately after the training, and one month later. The ultimate test was on an anesthetized rat—the real test of transfer of learning!

Both groups showed immediate improvement in performance. But, based on expert measures, the distributed group retained better. Most importantly, the distributed group beat the others hands down on all criteria in the real live rat test!

Engaged learning, true transfer

All of us may not end up repairing micro vessels to save lives, but all of us do forget. The learning program might be both rigorous and engaging (the latter mainly because of your meaningful involvement) but you are unlikely to recollect every sequence of the intricate procedure.

What matters is how well you apply the learning. This is where spaced practice is critical especially when lives are at stake.

Imagine a pilot spending several hours at a stretch in a flight simulator and then stepping out to pilot a regular passenger plane. They are better off learning the science and then practicing it alternatively as they move up the learning ladder.

When retrieval of information and its correct application in a novel situation are the needs of the hour, designing for learning engagement can save lives.

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