Spacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. The searches yielded 1662 unique publications. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. Repeated practice, or spacing, can improve various types of skill acquisition.

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