Structured Prebriefing and Worked-Out Modeling to Reduce Cognitive Overload During an Interprofessional Simulation

To compare self-perceived cognitive load between participants who received structured prebriefing and worked-out modeling (WOM) before an interprofessional escape room simulation vs those who received the usual presimulation orientation. A secondary outcome was to explore differences in observed and self-reported team dynamics.

One hundred ten students participated in a 3.5-h interprofessional education (IPE) activity featuring a pediatric escape room. Teams were randomized into a control (14 teams) and intervention (15 teams) arm. The control arm received a 30-min orientation, including a team icebreaker, and then proceeded to the escape room. The intervention group received the same orientation, plus a structured prebriefing on psychological safety, available resources, and good team behaviors, and WOM using 5 pediatric cases. In the escape room, an observer assessed team performance using the TeamSTEPPS performance observation tool. Immediately after the escape room, students completed the Cognitive Load Assessment Scales in Simulation and the Performance Assessment Communication and Teamwork Tools Set (PACT) postassessment form. The Mann-Whitney U test and independent t test were used to compare the 2 arms.

The intervention group reported significantly higher germane load and lower extraneous load. On the observer form, statistically significant higher total scores were noted for the intervention arm on 1 item related to the team structure domain. On the PACT postassessment, the intervention arm reported more instances of leadership skills.

Incorporating prebriefing and WOM before an IPE experience improves germane load, reduces extraneous load, and may improve team dynamics relating to leadership.