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The Effect of an Interval Training on Skill Retention of High-Complex Low-Volume Minimal Invasive Pediatric Surgery Skills: A Pilot Study.

  • Joosten, Maja1
  • Bökkerink, Guus M J2
  • Stals, Jolien J M1
  • Leijte, Erik1
  • De Blaauw, Ivo1
  • Botden, Sanne M B I1
  • 1 Department of Pediatric Surgery, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands. , (Mali)
  • 2 Department of Pediatric Surgery, Princess Máxima Center, Utrecht, The Netherlands. , (Netherlands)
Published Article
Journal of laparoendoscopic & advanced surgical techniques. Part A
Publication Date
Apr 30, 2021
DOI: 10.1089/lap.2020.1024
PMID: 33944585


Background: Current training programs for complex pediatric minimal invasive surgery (MIS) are usually bulk training, consisting of 1- or 2-day courses. The aim of this study was to examine the effects of bulk training versus interval training on the preservation of high-complex, low-volume MIS skills. Materials and Methods: Medical students, without prior surgical experience, were randomly assigned to either a bulk or interval training program for complex MIS (congenital diaphragmatic hernia [CDH] and esophageal atresia [EA] repair). Both groups trained for 5 hours; the bulk group twice within 3 days and the interval groups five times in 3 weeks. Skills retention was assessed at 2 weeks, 6 weeks, and 6 months posttraining, using a composite score (0%-100%) based on the objective parameters tracked by SurgTrac. Results: Seventeen students completed the training sessions (bulk n = 9, interval n = 8) and were assessed accordingly. Retention of the skills for EA repair was significantly better for the interval training group than for the bulk group at 6 weeks (P = .004). However, at 6 months, both groups scored significantly worse than after the training sessions for EA repair (bulk 60 versus 67, P = .176; interval 63 versus 74, P = .028) and CDH repair (bulk 32 versus 67, P = .018; interval 47 versus 62, P = .176). Conclusion: This pilot study suggests superior retention of complex pediatric MIS skills after interval training, during a longer period of time, than bulk training. However, after 6 months, both groups scored significantly worse than after their training, indicating the need for continuous training.

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