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Evidence for validity for the Cognitive Load Inventory for Handoffs.

John Q Young1,2, Majnu John3, Krima Thakker4

  • 1Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.

Medical Education
|July 16, 2020
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Summary

Patient handovers are a safety challenge. The new Cognitive Load Inventory for Handoffs (CLIH) measures cognitive load types, aiding in developing better handover protocols and training for healthcare professionals.

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Area of Science:

  • Medical Education
  • Patient Safety
  • Cognitive Psychology

Background:

  • Patient handovers are critical for safe care transitions.
  • Cognitive load during handovers can lead to errors.
  • Existing tools to measure cognitive load during handovers are lacking.

Purpose of the Study:

  • To develop and validate the Cognitive Load Inventory for Handoffs (CLIH).
  • To measure intrinsic, extraneous, and germane cognitive load during patient handovers.
  • To provide an instrument for optimizing handover education and protocols.

Main Methods:

  • Developed the CLIH through expert interviews and talk-alouds.
  • Administered a survey to 1807 residents and fellows.
  • Utilized exploratory and confirmatory factor analysis to assess the instrument's validity and reliability.

Main Results:

  • The final 16-item CLIH demonstrated a valid three-factor model (intrinsic, extraneous, germane load).
  • The instrument showed good model fit (CFI=0.95, TFI=0.93, RMSEA=0.074, SRMR=0.07).
  • Scales exhibited high internal consistency and were associated with postgraduate level and clinical setting.

Conclusions:

  • The CLIH effectively measures three types of cognitive load during patient handovers.
  • The instrument provides evidence of validity for content, response process, internal structure, and associations.
  • The CLIH can identify key cognitive load drivers to improve handover practices and training.