Applying cognitive load theory to medical education: construct and measurement challenges

Young, John Q.; Sewell, Justin L.

doi:10.1007/s40037-015-0193-9

Cited by 40 publications

(58 citation statements)

References 12 publications

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“…Whether germane load should be considered a unique construct or whether it is best conceptualised as an aspect of intrinsic load is under debate . Intuitively, completing a task and learning from a task are related, yet require different cognitive activities.…”

Section: Discussionmentioning

confidence: 99%

“…Extraneous load should be minimised and intrinsic load matched to the learner's experience level; in the motivated learner, this provides working memory space for cognitive activities promoting germane load and learning . Whereas intrinsic and extraneous load are considered incontrovertible types of cognitive load, debate exists as to whether germane load is a unique form of cognitive load or whether it is a component of intrinsic load . Because germane load is the cognitive load type most directly linked to learning, educators should find it of great interest.…”

Section: Introductionmentioning

confidence: 99%

“…4 Whereas intrinsic and extraneous load are considered incontrovertible types of cognitive load, debate exists as to whether germane load is a unique form of cognitive load or whether it is a component of intrinsic load. [5][6][7] Because germane load is the cognitive load type most directly linked to learning, educators should find it of great interest. However, we know little about the factors or variables that impact germane load in health professions education (HPE) workplace settings, and it remains less studied than intrinsic and extraneous load.…”

Section: Introductionmentioning

confidence: 99%

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Trainee perception of cognitive load during observed faculty staff teaching of procedural skills

et al. 2019

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Objectives Although teachers impact learners’ cognitive load, how specific teaching activities affect intrinsic, germane and extraneous load during procedural skills training is unknown. We sought to characterise teaching activities used in the exemplar procedural setting of colonoscopy, and to explore how they were enacted and how learners perceived them as affecting intrinsic, germane and extraneous cognitive load. Methods We observed 10 colonoscopies performed by eight different gastroenterology fellows and supervised by 10 different attending physicians at two hospitals, and recorded the teaching activities observed, as well as details of when they were used and how they were enacted. After the colonoscopy, each fellow completed the Cognitive Load Inventory for Colonoscopy to quantify intrinsic, germane and extraneous load. We then interviewed each fellow to determine how he or she perceived teaching as affecting cognitive load. Qualitative data were subjected to content analysis. Instances of germane load‐promoting activities were correlated with measured germane load. Results We observed 515 instances of teaching activities. The intensity of teaching varied substantially, ranging from 0.7 to 3.3 activities per minute, as did the pattern of teaching activities used by different attending physicians. Little teaching occurred immediately before or after a procedure. Fellows usually perceived teaching as affecting cognitive load in ways that promoted learning, particularly by reducing intrinsic load and increasing germane load. Fellows strongly perceived that the provision of autonomy promoted germane load. Conversely, fellows perceived that excessive teaching increased extraneous load. Instances of germane load‐promoting teaching activities correlated moderately with measured germane load. Conclusions Teaching in the exemplar procedural setting of colonoscopy affected learners’ cognitive load in mostly beneficial ways, yet even ‘good’ teaching activities had detrimental effects when used excessively. Teachers of procedures should consider learner experience, task complexity and environmental factors to modulate the modality, content and intensity of teaching to promote balanced cognitive load and learning. Teaching more reservedly during the procedure and taking advantage of pre‐ and post‐procedure opportunities may help.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trainee perception of cognitive load during observed faculty staff teaching of procedural skills

et al. 2019

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“…CLT has been proposed as a framework which can be applied to curricular design and delivery in medical education, to reduce extraneous cognitive load, optimise the intrinsic load, and facilitate the germane load. (Leppink and van den Heuvel, 2015;Young and Sewell, 2015) Situated Learning Proposed by Lave and Wenger, Situated Learning Theory (Lave and Wenger, 1991) suggests that learning occurs through the learners' participation in the context of community activities. Learners transform their roles, understanding and responsibilities as they practice.…”

Section: Cognitive Load Theorymentioning

confidence: 99%

SimRound, A novel approach to transitions of Junior Medical Students into Clinical Clerkships: Rationale, Development and Lessons Learnt

Wong¹,

Archarya²,

Mok³

et al. 2018

MedEdPublish

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IntroductionJunior students making the transition from pre-clinical to clinical years often struggle to integrate into ward teams during ward-round activities. The SimRound is a novel approach to facilitate embedding of junior medical students into incumbent ward teams through simulation rounds specially designed to replicate actual ward-round proceedings. Using the situated learning and cognitive load theories, this study aims to describe the rationale, processes and lessons learnt from our experience in developing the SimRound. MethodsThird-year students undergo two SimRound sessions at weeks two and six during the eight-week General Medicine clerkship. There are four phases in each SimRound: Prioritisation and triage; pre-round; consultant round; and evaluation and feedback. Using framework analysis, we compared open-ended survey data from pre-SimRound and SimRound cohorts to develop descriptive and explanatory accounts of identified themes. ResultsDespite the benefits to learning from being embedded in the ward team, students reported challenges to learning arising from engagement and team identity; increased intrinsic load; and increased extraneous load. SimRound addresses this by enabling deliberate learning in a controlled and authentic setting with inter-professional participation. The reduction of cognitive load enabled students to assimilate the necessary knowledge and skills.In conclusion, SimRound complements embedding and facilitates the integration of junior students into the community of practice of incumbent ward teams.

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“…In their 2015 review detailing the challenges of construct and measurement in cognitive load theory (CLT), Young and Sewell proposed the role of psychometrics in the more reliable measurement of cognitive load (CL) . In this issue, Sewell et al .…”

mentioning

confidence: 99%

Reliable cognitive load measurement using psychometrics: towards a model of objective teaching programme optimisation

Lau

Moeller

2016

Med Educ

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Applying cognitive load theory to medical education: construct and measurement challenges

Abstract: None

Cited by 40 publications

References 12 publications

Trainee perception of cognitive load during observed faculty staff teaching of procedural skills

Trainee perception of cognitive load during observed faculty staff teaching of procedural skills

SimRound, A novel approach to transitions of Junior Medical Students into Clinical Clerkships: Rationale, Development and Lessons Learnt

Reliable cognitive load measurement using psychometrics: towards a model of objective teaching programme optimisation

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