Abstract
During their course, medical students have to become proficient in a variety of competencies. For each of these competencies, educational design can use cognitive load theory to consider three dimensions: task fidelity: from literature (lowest) through simulated patients (medium) to real patients (highest); task complexity: the number of information elements in a learning task; and instructional support: from worked examples (highest) through completion tasks (medium) to autonomous task performance (lowest). One should integrate any competency into a medical curriculum such that training in that competency facilitates the students’ journey that starts from high instructional support on low-complexity low-fidelity learning tasks all the way to high-complexity tasks in high-fidelity environments carried out autonomously. This article presents twelve tips on using cognitive load theory or, more specifically, a set of four tips for each of task fidelity, task complexity, and instructional support, to achieve that aim.
Highlights
Medical students have to develop a number of competencies during their training, such as conducting a patient interview, selecting appropriate diagnostic procedures, and formulating a management plan
One should integrate any competency into a medical curriculum such that training in that competency facilitates the students’ journey that starts from high instructional support on low-complexity low-fidelity learning tasks all the way to highcomplexity tasks in high-fidelity environments carried out autonomously
The three sets of four tips presented in this article on how to achieve this aim can be summarized in the following three bullet points: Task fidelity: to avoid cognitive and/or emotional overload, we move up from literature through simulated patients to real patients; starting at or moving to a higher level of fidelity should be accompanied by sufficient instructional support
Summary
Medical students have to develop a number of competencies during their training, such as conducting a patient interview, selecting appropriate diagnostic procedures, and formulating a management plan. When learning how to do this for the first time, provide students with step-by-step instructions and feedback, only provide them with feedback, and provide no feedback at all This principle of gradually fading support is to be repeated at subsequent complexity and fidelity levels. Another frequently used instrument is the NASA Task Load index, which uses a visual analogue scale to indicate the perceived level on six subscales: mental demand; physical demand, temporal demand; performance; effort; and frustration (Hart & Staveland 1988) When timed carefully, these measures can help teachers and curriculum developers to understand to what extent specific choices made on the dimensions of the cube may stimulate or hamper learning on the part of individual learners. Apart from qualitative and quantitative indicators of performance in formative assessments, teachers and curriculum developers should consider keeping track of cognitive load experienced by their students along the way
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