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The Cognitive Load of Inpatient Consults: A Convergent Parallel Mixed Methods Study Using the Consult Cognitive Load

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Understanding fellow cognitive load during inpatient consults revealed key themes. Strategies to manage intrinsic, extraneous, and germane load can enhance fellow education and patient care.

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Area of Science:

  • Medical Education
  • Cognitive Psychology
  • Healthcare Management

Background:

  • Consultation is a core responsibility for fellows, impacting patient care.
  • Understanding the cognitive load during consultations is vital for improving fellow learning and performance.

Purpose of the Study:

  • To identify themes in the fellow experience during inpatient consults.
  • To correlate these themes with Consult Cognitive Load (CCL) scores.
  • To identify strategies for managing cognitive load to enhance fellow education and patient care.

Main Methods:

  • Mixed-methods study involving 16 fellows.
  • Post-consultation CCL assessment and interviews.
  • Thematic analysis of interviews, with member checks and triangulation for trustworthiness.
  • Correlation analysis between identified themes and CCL sub-scores (intrinsic, extraneous, germane load).

Main Results:

  • Four themes emerged: 'nature and scope' (intrinsic load), 'leveraging resources' (intrinsic/extraneous load), 'extraneous factors' (extraneous load), and 'drivers' (germane load).
  • Strong correlations were found between 'extraneous factors' and extraneous load (0.71).
  • Potential strategies include tailored assistance for intrinsic load, attention focus for extraneous load, and concise teaching for germane load.

Conclusions:

  • The study offers insights into the fellow consultation experience and proposes actionable strategies for educators.
  • The theme 'leveraging resources' requires further investigation for its role in managing cognitive load.