Comparing Distributed Practice Models for Medical Student Procedural Skills Teaching: A Randomized Pilot Study

Background: Distributed practice is ideal for teaching procedural skills, yet the optimal time interval between learning sessions remains unclear. We employed a distributed practice model to determine the interval that maximizes skill retention among medical students performing a horizontal mattress suture. Methods: We taught participants the skill and assessed their proficiency using two previously validated scoring tools. Participants returned at two weeks, one month, or three months for retesting. At their second session, students either received a brief refresher module prior to testing or completed immediate testing. Learners also completed a survey. Results: Thirty-one students completed the study. At two weeks, we found no statistical difference between the refresher and immediate-testing groups (p = 0.86; CI 0.2-0.6). At one month, the difference remained nonsignificant (p = 0.13; CI 0.1-0.4), although confidence intervals narrowed. At three months, we observed a statistically significant difference between groups (adjusted p < 0.0001; CI 0.06-0.2). Survey results indicated no significant differences (p = 0.14), suggesting a homogeneous distribution of learners. Conclusion: We found that a brief refresher module enhances suture skill retention, with results suggesting that the optimal interval for review sessions should occur one to three months after initial instruction.