Measuring cognitive load: mixed results from a handover simulation for medical students

Area of Science:

• Cognitive Psychology
• Medical Education
• Human Factors Engineering

Background:

• Measuring cognitive load during workplace activities like patient handovers is crucial but lacks validated tools.
• Cognitive Load Theory provides a framework, but its application in healthcare settings requires specific instruments.

Purpose of the Study:

• To develop and test the Cognitive Load Inventory for Handoffs (CLI4H) to measure intrinsic, extraneous, and germane cognitive load during simulated patient handovers.
• To gather initial evidence for the validity and reliability of the CLI4H.

Main Methods:

• The CLI4H was developed with items targeting different cognitive load types.
• Medical students completed the CLI4H after a simulated handover task.
• Exploratory factor and correlation analyses were used to assess the instrument's validity.

Main Results:

• A two-factor solution for intrinsic and germane load explained 50% of the variance; extraneous load items were removed.
• Intrinsic load scores correlated with an established scale and were lower with more training, but not with performance.
• Germane load scores correlated with performance and were lower with more training, but not with an established scale.

Conclusions:

• The CLI4H shows some promise for measuring intrinsic load, but requires further refinement, particularly for extraneous and germane load components.
• The study highlights the need for validated cognitive load measures in healthcare settings.
• Limitations include the poor performance of extraneous load items and a single item for germane load, necessitating further development and testing.