The Impact of Simulation-Based Spaced Training for Skills Acquisition on Learning and Performance Outcomes Among Healthcare Professionals

Summary Statement Spaced learning is increasingly used in simulation-based education, yet its impact on learning, performance, and patient outcomes is unclear. We compared spaced training (several discrete sessions) with massed training (a single session) for skills acquisition in health professionals. We systematically reviewed randomized or prospective comparative studies. Of 4572 citations screened, 15 met inclusion criteria. Studies covered resuscitation and surgical procedures, most with spacing intervals of about 1 week. Despite heterogeneity in study design, participants, and outcomes, spaced training was generally as effective as massed training. Some evidence suggested advantages for spaced training in skill retention, particularly for time to complete procedures. Findings were inconsistent across other outcomes. No studies demonstrated improvements in patient care practices, patient outcomes, or broader educational effects. These results suggest spaced simulation may offer retention benefits for certain skills, but more research is needed to assess its impact on clinical and system-level outcomes.