Influence of learner knowledge and case complexity on handover accuracy and cognitive load: results from a simulation...

Area of Science:

• Medical Education
• Cognitive Psychology
• Patient Safety

Background:

• Patient handovers are high-risk events prone to errors causing patient harm.
• Understanding cognitive mechanisms of handover errors is crucial for improving education and practice.

Purpose of the Study:

• To investigate the impact of learner knowledge and case complexity on handover accuracy and cognitive load.
• To examine the interaction between knowledge and complexity in simulated medical handovers.

Main Methods:

• 52 Dutch medical students (Years 2 and 6) participated in a repeated-measures experiment.
• Assessed handover accuracy and cognitive load across simple and complex simulated cases.
• Illness script maturity (learner knowledge) was a covariate, case complexity was within-subject.

Main Results:

• Higher illness script maturity correlated with increased handover accuracy and decreased cognitive load.
• Case complexity did not independently influence accuracy or cognitive load.
• An interaction for cognitive load showed mature illness scripts reduced load less in complex cases.

Conclusions:

• Trainees with more developed illness scripts achieve better handover accuracy and lower cognitive load.
• The benefit of mature illness scripts on cognitive load is greater for simple cases.
• Handover training should be individualized based on trainee knowledge levels.