Abstract
Purpose: Cognitive load theory (CLT) is receiving increased recognition in medical education and it was cited as an important theoretical framework for simulation-based medical education. Simulated learning environments can place a high demand on the cognitive resources of the learners, hence, we aimed to design an instructional framework to optimise the total cognitive load imposed on the medical students during their clinical skills training in the clinical skills laboratory. Method: This study is a quasi-experimental post-test design. The sampling technique was purposive sampling, which included year 2 students at the Faculty of Medicine-Suez Canal University population. The study was conducted in the clinical skills and simulation laboratory. The intervention group received a developed instructional design framework based on CLT. The control group learned with the ordinary teaching method without any intervention. The cognitive load was measured using the Cognitive Load Inventory (CLI) immediately after the training session for both groups. Furthermore, students’ achievement in the clinical skill laboratory was compared in both groups. Findings: The total cognitive load is lower in the group that received the developed instructional design than that of the control group, and this result was statistically significant. Also, the performance of the intervention group is higher than in the control group. Implications for research and practice: The developed instructional design framework is a potentially useful guide for managing students' cognitive load in the clinical skills training session.
Highlights
Simulated learning environments place a high demand on the cognitive resources of the learners’ working memory
Cognitive load theory (CLT) is being increasingly cited as an important theoretical framework for simulation-based medical education, because simulated learning environments can place a high demand on the cognitive resources of the learners Reedy (2015)
The current results showed that total cognitive load was lower in the intervention group, compared to the control group, especially in intrinsic load, which indicates that knowledge and skills have been consolidated in the long-term memory
Summary
Simulated learning environments place a high demand on the cognitive resources of the learners’ working memory. Emotions experienced by students in a simulated environment will affect what they learn Tremblay et al, (2017) Most studies in this area focused on measuring CLT, or testing contributors to this construct, little research worked on developing an instructional framework based on CLT especially in a clinical simulated environment. CLT is an example of a wide variety of theories adopted by medical education from other fields as originated in educational psychology Kalyuga (2011) This theory explains learning according to three important aspects: the types of memory (working and long-term memory), the learning process, and the forms of cognitive load that affect our learning Sweller (1988). There has been little research that worked on the development of an instructional design, based on CLT, during clinical skills training in health simulation education Fraser et al, (2012)
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