Healthcare students must absorb an enormous amount of information over a short period of time. Learn about the different types of cognitive load, some challenges with each type, and strategies to reduce the negative impacts on cognitive load in today’s Osmosis blog.
Have you ever wondered whether or not your students fully comprehend the information you teach in class? When it comes to such a multifaceted education journey as healthcare, you’re not alone.
In 1988, psychologist John Sweller developed Cognitive Load Theory and published “Cognitive Load During Problem-Solving: Effects on Learning” in the journal Cognitive Science. “Cognitive load” relates to the amount of information working memory can hold at one time. In healthcare education, understanding cognitive load theory can help you teach more effectively and help your students retain more information.
Types of Cognitive Load
Cognitive load theory is a living theory that is being adjusted based on new studies. Currently, there are two kinds of cognitive load:
- Intrinsic cognitive load: load related to the learning task, like the topic of a lecture, or the skill you’re supposed to practice. It’s the “good” load that’s intended and expected to be there.
- Extraneous cognitive load: load not related to learning a task. This can be irrelevant sounds and images from the surrounding environment or from the instructional content itself containing unnecessary details that overcomplicate learning.
Together, the intrinsic and extraneous loads make up the total cognitive load. The general goal is to limit extraneous load. However, there’s a third important factor that used to be called germane load and is now also called germane processing. Germane processing is the capacity of the working memory to link new ideas with information in the long-term memory. You can think of this as the attention you’re giving to learning at a given time.
The ideal combination of these two types of cognitive load for healthcare education is to manage how complicated a learning task is for students (intrinsic load) and reduce distracting material (extraneous load) to encourage successful germane processing.
Cognitive Load Theory
Cognitive Load Theory builds on the premise that working memory has a limited capacity and that overloading it reduces the ability of students to move information from working memory to long-term memory. Its principal applications are to offer practical strategies to optimize learning within education settings. Cognitive load theory can help you design training or learning materials that reduce the demands on a learner’s working memory, so they learn more effectively.
Learning is hard or impossible when the total cognitive load on students is too high. If you overload a student’s working memory with intrinsic load (making the task too difficult to comprehend or carry out) or extraneous load (giving too many distracting stimuli), you don’t leave enough to achieve successful germane processing levels.
Cognitive Load in Healthcare Education
As with any field, specific cognitive load challenges arise within healthcare education, depending on the topic. Medical students may experience different cognitive load challenges than nursing or dental students.
For example, seasoned endoscopy teachers described the cognitive load learning challenges they witnessed students experience relate to a combination of:
- Trainees: (performance over mastery goal orientation, low self-efficacy, lack of awareness)
- Tasks: (psychomotor challenges, mental model development, tactile understanding)
- Teachers: (teacher-trainee relationship, inadequate teaching, teaching variability)
- Settings: (internal/external distractions, systems issues)
Although healthcare education cognitive load varies, typical examples of high cognitive load activities include:
- Presenting hard-to-read diagrams or charts with too much information
- Teaching complex medical procedures with limitations in visual and tactile information
- Proceeding with complicated information before students grasp foundational information
Ultimately, challenges of cognitive load in healthcare education exist, and educators who understand these challenges can execute teaching strategies that best support learners.
Strategies to Reduce Cognitive Load in Healthcare Education
The following strategies support strong learning environments and reduce cognitive load for optimal information retention.
Active learning strategies
Active learning encourages students to engage with the material through an activity or exercise with the instructor as a learning facilitator and guide. The process promotes higher-order thinking while students learn to apply knowledge in a safe space.
Active learning exercises to implement in the classroom include multiple-choice questions, open-ended questions, and concept maps.
Multimedia and technology
Using a variety of media and technology, like Osmosis, during instructional time can benefit students by reinforcing information in a different way. Richard Mayer’s 12 Principles of Multimedia Learning strategy helps educators design presentations as they directly relate to all three types of cognitive load.
For example, focusing narrowly on the essential material and refraining from everything that could distract learners (such as irrelevant illustrations or information) minimizes extraneous load. Additionally, allowing students to control the pace of the lesson during asynchronous lessons, such as with speed controls or “next” buttons, manages intrinsic load.
Simplification of complex information
The primary way to simplify complex information is to present it both verbally and visually. This strategy increases the capacity of students’ germane processing, or working memories, creating more mental space for learning.
This strategy also supports students’ different learning preferences. Researchers note three main styles: visual, auditory, and kinesthetic. The conclusion states, “The most important aspect is that the prevailing styles of learning are the visual and auditory ones, therefore, the medical information should be structured and transmitted using both sensory channels equally…” further supporting this strategy.
Collaborative learning
Cognitive load decreases when people work in small groups to help each other learn. Research shows three aspects of collaborative learning to consider during instructional design including the learning task, the individual learners, and the group. Important principles to keep in mind for collaborative learning:
- Make sure to provide sufficient guidance and support for completing the learning tasks so collaborative learning is effective.
- Collaborative learning is most effective for complex learning tasks and problem-solving that is likely to exceed the working memory resources for learners.
- Groups of people who have previously worked together will have decreased cognitive load because they have already figured out how to communicate, share knowledge, and distribute tasks.
Conclusion
When you understand that working memory has a limited capacity and overloading reduces the ability to learn effectively, you know how to teach students better. The key is to be aware of the variety of learning preferences and do your best to provide materials that support each one.Whether teaching surgical residents in an operating room or pharmacy residents in an inpatient pharmacy, faculty and students will benefit from incorporating cognitive load theory into teaching methodologies.
Contributors
Chantel Nguyen, Osmosis Brand Marketing Lead
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