I've found low cadence work to be a huge waste of effort, just as effective if you do it at your preferred cadence. Don't have any scientific evidence to back it up, but i do remember andy coggan saying that cadence work is a waste too (Correct me if i'm wrong), and he's pretty credible.

For triathlon or TT I'd agree. (given that I'm Coggan/100000) For most mass start cycling having a wider range of effective torque can be beneficial. E.g. Alaphillipe up the Muur this morning probably had insane torque values at very low cadence on the 25% grade section.

So what’s the difference (if any) between doing hill repeats vs flat intervals if the duration and wattage are similar?

Granted my PM has been broken in recent times, but it ‘seems’ like perhaps it’s easier to hold higher wattage on hills because of the perception that lower speeds trick me into thinking I’m not working as hard.

For me , I can always generate higher power on hills.

I’ve felt that the slower speeds allow me to focus on pedaling, whereas on a flat / downhill I’m going much faster and have to worry about that in some part of my brain

As far as adaptation - I say train somewhat how you will race.

If you do Flat TTS or Olys, I don’t see why training at low cadence would benefit you as much as it would for a hilly road race where you’ll be forced to ride some times in very low cadences

It may be harder on a trainer as it’s almost impossible to distinguish between a ‘hill’ vs flat interval (no wind differential to simulate speed).

Don’t know how much the muscles get hit differently by throwing old phone books under the front wheel.

Responses are a bit of an eye opener.

Almost all people are going to be able to put out more power on a climb than flat when doing interval. The grade is pretty constant it's a near iso power workout.

Couple of examples from power files from this past weekend.
Athlete A rides a 25 min climb AP 289/NP 290
Athlete B does a 25 min interval on flat roads and it was very windy 302 AP/ 313 NP

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Brian Stover USAT LII
Accelerate3 Coaching
Insta

In a trainer zero. In the road it is significant due to pedaling inertia. Something that is not discussed often.

Based on my experience I wouldn't bother with the phone books. I went to the Alps last summer after a year of training entirely almost indoors and on the flat outdoors. Literally rode 5,000 miles in that year with total elevation of less than 50,000 feet, and then nearly doubled that elevation in 3 days of riding. Was obviously pretty nervous, but didn't need to be - turned out that the only thing that really matters with climbing is watts and kgs, and since I was in good shape on both those numbers I was fine. I guess it helped that I'd done enough mountain riding in the past to be able to pace myself well and not care about speed. I think riding outside it is "easier" to push higher watts riding uphill than on the flat, would assume that's a mixture of inertia and maybe mental motivation. In erg mode I don't see how it makes any difference, you're pushing the prescribed watts until you stop pedalling.

Cadence matters only if you're going to be in situations where you're running out of gears (high or low), and/or in race situations where you may not want to be shifting gear (e. g. middle of a sprint). For triathletes or TTers on rolling courses I really don't think it matters. If you're going to be riding up >20% gradients at 50rpm or launching sprints where you need to generate power at 120+rpm then you need to train to ride those cadences.