The Cognitive Load of Inpatient Consults: Development of the Consult Cognitive Load Instrument and Initial Validity...

Area of Science:

• Medical Education Research
• Cognitive Psychology

Background:

• Inpatient consultations are crucial learning experiences for medical trainees.
• Accurate measurement of cognitive load (CL) is essential for optimizing learning during these consults.
• Existing CL instruments, like the Paas scale, are unidimensional and may not capture the complexities of consult-related CL.

Purpose of the Study:

• To develop and validate the Consult Cognitive Load (CCL) instrument.
• To measure the three distinct components of cognitive load during inpatient medical consultations.
• To provide a more nuanced assessment of cognitive load compared to existing unidimensional scales.

Main Methods:

• The CCL was developed using Wilson's constructive approach, incorporating literature review, expert consultation, and cognitive interviews.
• Validity evidence was gathered by administering the CCL to internal medicine and psychiatry trainees across five University of California campuses.
• Statistical analyses included Rasch models, linear regression, Wright maps, and latent correlations to assess validity and compare with the Paas scale.

Main Results:

• The CCL demonstrated appropriate fit statistics and relationships with predictor variables, indicating good validity.
• The CCL provided broader coverage of the three CL components compared to the Paas scale.
• Low correlations among the three CL components suggest the CCL captures distinct aspects of cognitive load.

Conclusions:

• Initial validity evidence supports the use of the CCL for measuring consult-related cognitive load.
• Measuring the three CL components separately offers greater nuance than a single, unidimensional CL score.
• The CCL can be used by learners and faculty for reflection, metacognition, and coaching to enhance the learning experience.