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Cognitive Load in Pediatric Critical Care Medicine: Tsunamis and a Thousand Cuts

Daniel E Ehrmann1, Sara N Gallant2, Sunkyung Yu1

  • 1Department of Pediatrics, Division of Cardiology, University of Michigan Medical School, Ann Arbor, MI.

Critical Care Explorations
|October 6, 2025
PubMed

Insights

Cognitive load in pediatric critical care medicine varies by role and task. Nurses experience high cognitive load during critical events and patient assessment, indicating a need for workflow improvements.

Area of Science:

  • Pediatric Critical Care Medicine
  • Human Factors Engineering
  • Occupational Health Psychology

Background:

  • Excessive cognitive load negatively impacts performance and can lead to burnout.
  • Limited research exists on cognitive load within pediatric critical care medicine (PCCM) settings.

Purpose of the Study:

  • To investigate cognitive load in an academic PCCM setting.
  • To determine how cognitive load varies by professional role, experience, task type, and frequency.

Main Methods:

  • A prospective two-part survey was conducted in a quaternary children's hospital PCCM department.
  • Participants included registered nurses (RNs), respiratory therapists (RTs), and physicians/advanced practice providers (APPs).
  • Cognitive load was assessed using the Paas scale for raw load and the NASA-Task Load Index (NASA-TLX) for acute resuscitation tasks.

Main Results:

  • Registered nurses reported higher raw cognitive load than physicians/APPs and RTs during critical events like resuscitation.
  • Nurses experienced higher net cognitive load during bedside patient assessment compared to other providers.
  • Nursing experience was correlated with overall net cognitive load.

Conclusions:

  • Cognitive load in PCCM is significantly influenced by professional role and specific task demands.
  • Nurses face substantial cognitive load during critical incidents and patient assessments, highlighting opportunities for targeted interventions.
  • Workflow redesign and cognitive load reduction strategies are recommended to support PCCM staff and enhance patient care.
Abstract

Keywords:
burnoutcognitive loadintensive carenursingpediatric intensive care

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