The Emotional and Cognitive Impact of Unexpected Simulated Patient Death

Fraser, Kristin; Huffman, James L.; Ma, Irene; Sobczak, Matthew; McIlwrick, Joanne; Wright, Bruce; McLaughlin, Kevin

doi:10.1378/chest.13-0987

Cited by 114 publications

(97 citation statements)

References 28 publications

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“…It is plausible to assume that a proportion of the work memory resources is used to "counter" the heightened state of anxiety, and on this basis, very little is left for processing of information. Similar evidence has been reported in a simulation training study in the area of Medical Education [66]. In this study by Fraser et al [66], the authors found that negative affective responses (e.g., anxiety) increased extraneous cognitive load imposition, which then led to a decrease in the working memory capacity for learning.…”

Section: Cognitive Load Imposition Internal Personal Processes and supporting

confidence: 82%

“…Similar evidence has been reported in a simulation training study in the area of Medical Education [66]. In this study by Fraser et al [66], the authors found that negative affective responses (e.g., anxiety) increased extraneous cognitive load imposition, which then led to a decrease in the working memory capacity for learning. However, from the results, the relationship between cognitive load imposition, positive emotions, and learning outcomes was less predictable.…”

Section: Cognitive Load Imposition Internal Personal Processes and supporting

confidence: 82%

See 1 more Smart Citation

Achievement Bests Framework, Cognitive Load Theory, and Equation Solving

Ngu¹,

Phan²

2018

New Pedagogical Challenges in the 21st Century - Contributions of Research in Education

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The Framework of Achievement Bests provides an explanatory account into the process of optimization, which details how a person reaches from one level of best practice to that of a more optimal level. This framework, we contend, is significant in its explanatory account of personal growth, an internal state of flourishing, and the achievement of exceptionality. This chapter conceptualizes the applicability of the Framework of Achievement Bests to the context of instructional designs. We highlight the tenet of element interactivity, which is integral to the design of a particular mathematics instruction and its potential effectiveness. Element interactivity entails the interaction between elements within a learning material. Owing to the limited working memory capacity, an instruction that incurs high level of element interactivity would impose high cognitive load leading to reduced learning. Our conceptualization postulates the possible alignment between suboptimal and optimal instructional designs with realistic and optimal levels of best practice, respectively. This postulation (e.g., suboptimal instructional design → realistic level of best practice), which recognizes the importance of cognitive load imposition, is significant from a practical point of view. By focusing on instructional designs, it is possible to assist individuals to achieve optimal best practice in learning.

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Section: Cognitive Load Imposition Internal Personal Processes and supporting

confidence: 82%

Section: Cognitive Load Imposition Internal Personal Processes and supporting

confidence: 82%

Achievement Bests Framework, Cognitive Load Theory, and Equation Solving

Ngu¹,

Phan²

2018

New Pedagogical Challenges in the 21st Century - Contributions of Research in Education

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“…In a recent randomized controlled trial of final year medical students participating in simulation, the unexpected death of the simulated patient increased the report of negative-activating emotions compared with the control intervention, mannequin survival. 75 Learners who experienced the mannequin death were also found to have higher self-rated cognitive load 78 and poorer learning outcomes measured objectively 6 weeks later, compared with the control learners. Among the potential untoward effects of mannequin death during simulations, it now seems that some learners are less likely to reach desired learning goals because of the extraneous cognitive load imposed by associated emotions.…”

Section: Emotion As Extraneous Loadmentioning

confidence: 93%

Cognitive Load Theory for the Design of Medical Simulations

Fraser

Ayres

Sweller

2015

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare

203

164

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Simulation-based education (SBE) has emerged as an effective and important tool for medical educators, but research about how to optimize training with simulators is in its infancy. It is often difficult to generalize results from experiments on instructional design issues in simulation because of the heterogeneity of learner groups, teaching methods, and rapidly changing technologies. We have found that cognitive load theory is highly relevant to teaching in the simulation laboratory and a useful conceptual framework to reference when designing or researching simulation-based education. Herein, we briefly describe cognitive load theory, its grounding in our current understanding of cognitive architecture, and the evidence supporting it. We focus our discussion on a few well-established cognitive load effects with examples from simulation training and recommend some instructional applications with theoretical potential to improve learning outcomes.

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“…A study in medical students has indeed shown that participants exposed to a simulated patient death reported increased cognitive load. 18 Other authors believe that simulated death negatively affects performance: "Mock codes should not end in death. When they do, the participants become so focused on the act of dying that the objectives of the scenario become secondary and the learning experience is compromised."…”

Section: Discussionmentioning

confidence: 99%