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Cognitive Load Effect on Intraoperative Learning - A Randomized Trial in Simulation-Based Settings.
Mohammed F Shaheen1, Abdulrahman Alhabeeb2, Fareeda Mukhtar3
1College of Medicine, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Hepatobiliary Sciences Department and Organ Transplant Center, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.
Simulating a noisy operating room (OR) increased cognitive load (CL) and impaired surgical trainees' knowledge acquisition during chest tube insertion training. Managing CL is crucial for effective surgical education.
Area of Science:
- Medical Education
- Surgical Training
- Cognitive Psychology
Background:
- Operating room (OR) distractions increase cognitive load (CL) in surgical trainees, potentially hindering learning.
- The impact of intraoperative teaching within a high-stress OR environment on CL and knowledge acquisition is not well understood.
Purpose of the Study:
- To investigate the effect of a noisy OR simulation on cognitive load and knowledge acquisition in surgical trainees during a chest tube insertion procedure.
- To compare learning outcomes between trainees in a low-stress versus a noisy OR simulation environment.
Main Methods:
- A randomized controlled trial involved 61 medical students, divided into a control group (low-stress simulation) and an experimental group (noisy OR simulation).
- Cognitive load was measured using subjective scales (m-MCLS) and objective methods (heart rate, tactile response task).
- Knowledge acquisition was assessed via post-simulation quiz scores.
Main Results:
- The noisy OR simulation group (EG) experienced significantly higher extraneous cognitive load (p < 0.001).
- Objective measures showed more attentional lapses in the EG (skipped TRT responses: 19% vs. 5.3%, p < 0.001).
- Knowledge acquisition was impaired in the EG, with lower quiz scores (57.4% vs. 67.5%, p = 0.02).
Conclusions:
- A realistic, noisy OR simulation intensifies cognitive load and negatively impacts surgical trainees' knowledge acquisition.
- Integrating cognitive load management strategies into surgical training curricula is recommended to improve performance.
- Further research is needed to determine optimal simulation realism and interventions for mitigating negative learning impacts.
