Cognitive Load Assessment Scales in Simulation: Validity Evidence for a Novel Measure of Cognitive Load Types.

Area of Science:

• Medical Education
• Cognitive Psychology

Background:

• Cognitive load theory is crucial for effective simulation-based medical education.
• Existing measures for intrinsic, extraneous, and germane load in simulations are insufficient.
• The Cognitive Load Assessment Scales in Simulation (CLAS-Sim) was developed to address this gap.

Purpose of the Study:

• To develop and validate the Cognitive Load Assessment Scales in Simulation (CLAS-Sim).
• To assess the reliability and validity of CLAS-Sim in measuring different types of cognitive load.
• To examine the impact of simulation design on cognitive load.

Main Methods:

• A quasi-experimental study involving pediatric residents in complex and simple case simulations.
• Participants completed the 22-item CLAS-Sim after each simulation.
• Validity was assessed using Kane's framework, including principal component analysis, reliability testing, and correlations with existing measures.

Main Results:

• Principal component analysis identified three distinct scales for intrinsic, extraneous, and germane load (Cronbach's α: 0.68–0.77).
• CLAS-Sim scores correlated significantly with the Paas scale for overall cognitive load.
• Higher performers in complex cases reported lower intrinsic and total cognitive load.

Conclusions:

• The CLAS-Sim shows preliminary validity for differentiating cognitive load types in simulation.
• Further research is needed to refine CLAS-Sim and explore its application in diverse simulation designs.
• The findings support the use of CLAS-Sim for evaluating cognitive load and informing instructional design in medical simulation.