Measuring cognitive load during simulation-based psychomotor skills training: sensitivity of secondary-task performance and subjective ratings

Advances in Health Sciences Education

Volumn 20, Issue 5, 2015, Pages 1237-1253

  Haji, Faizal A ^a,b,c   Khan, Rabia ^a   Regehr, Glenn ^d   Drake, James ^b   de Ribaupierre, Sandrine ^c   Dubrowski, Adam ^e  

^a UNIVERSITY OF TORONTO   (Canada)

^b HOSPITAL FOR SICK CHILDREN   (Canada)

^c UNIVERSITY OF WESTERN ONTARIO   (Canada)

^d UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^e MEMORIAL UNIVERSITY OF NEWFOUNDLAND   (Canada)

Author keywords

Cognitive load; Dual task methodology; Mental effort; Novice learning; Psychomotor skills training; Simulation

Indexed keywords

CLINICAL COMPETENCE; COGNITION; HUMAN; LEARNING; MEDICAL EDUCATION; MEDICAL STUDENT; PHYSIOLOGIC MONITORING; PHYSIOLOGY; PROCEDURES; PSYCHOLOGICAL MODEL; PSYCHOMOTOR PERFORMANCE; REACTION TIME; SIMULATION TRAINING; SUTURE TECHNIQUE; TASK PERFORMANCE;

CLINICAL COMPETENCE; COGNITION; EDUCATION, MEDICAL, UNDERGRADUATE; HUMANS; LEARNING; MODELS, PSYCHOLOGICAL; MONITORING, PHYSIOLOGIC; PSYCHOMOTOR PERFORMANCE; REACTION TIME; SIMULATION TRAINING; STUDENTS, MEDICAL; SUTURE TECHNIQUES; TASK PERFORMANCE AND ANALYSIS;

EID: 84947046160     PISSN: 13824996     EISSN: 15731677     Source Type: Journal    
DOI: 10.1007/s10459-015-9599-8     Document Type: Article

References (54)

1. Antonenko, P., Paas, F., Grabner, R., & Van Gog, T. (2010). Using electroencephalography to measure cognitive load. Educational Psychology Review,22(4), 425–438.
2. Ayres, P. (2006). Using subjective measures to detect variations of intrinsic cognitive load within problems. Learning and Instruction,16(5), 389–400. doi:10.1016/j.learninstruc.2006.09.001.
3. Bjerrum, A. S., Hilberg, O., Van Gog, T., Charles, P., & Eika, B. (2013). Effects of modelling examples in complex procedural skills training: a randomised study. Medical Education,47(9), 888–898. doi:10.1111/medu.12199.
4. Brunken, R., Plass, J. L., & Leutner, D. (2003). Direct measurement of cognitive load in multimedia learning. Educational Psychologist,38(1), 53–61. doi:10.1207/S15326985EP3801_7.
5. Brunken, R., Steinbacher, S., Plass, J. L., & Leutner, D. (2002). Assessment of cognitive load in multimedia learning using dual-task methodology. Experimental Psychology (formerly “Zeitschrift für Experimentelle Psychologie”),49(2), 109–119. doi:10.1027//1618-3169.49.2.109.
6. Brydges, R., Classen, R., Larmer, J., Xeroulis, G., & Dubrowski, A. (2006). Computer-assisted assessment of one-handed knot tying skills performed within various contexts: A construct validity study. The American Journal of Surgery,192(1), 109–113. doi:10.1016/j.amjsurg.2005.11.014.
7. Carswell, C., Clarke, D., & Seales, W. (2005). Assessing mental workload during laparoscopic surgery. Surgical Innovation,12(1), 80–90.
8. Choi, H. H., van Merrienboer, J., & Paas, F. (2014). Effects of the physical environment on cognitive load and learning: Towards a new model of cognitive load. Educational Psychology Review,26, 225–244.
9. Cierniak, G., Scheiter, K., & Gerjets, P. (2009). Explaining the split-attention effect: Is the reduction of extraneous cognitive load accompanied by an increase in germane cognitive load? Computers in Human Behavior,25(2), 315–324. doi:10.1016/j.chb.2008.12.020.
10. Cook, D. A., Bordage, G., & Schmidt, H. G. (2008). Description, justification and clarification: A framework for classifying the purposes of research in medical education. Medical Education,42(2), 128–133. doi:10.1111/j.1365-2923.2007.02974.x.
11. Cook, D. A., Hamstra, S. J., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., et al. (2013). Comparative effectiveness of instructional design features in simulation-based education: Systematic review and meta-analysis. Medical Teacher,35(1), e844–e875. doi:10.3109/0142159X.2012.714886.
12. Cook, D. A., Hatala, R., Brydges, R., Zendejas, B., Szostek, J. H., Wang, A. T., et al. (2011). Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA The Journal of the American Medical Association,306(9), 978–988. doi:10.1001/jama.2011.1234.
13. Datta, V., Mackay, S., Mandalia, M., & Darzi, A. (2001). The use of electromagnetic motion tracking analysis to objectively measure open surgical skill in the laboratory-based model. Journal of the American College of Surgeons,193(5), 479–485.
14. Davis, D. H. J., Oliver, M., & Byrne, A. J. (2009). A novel method of measuring the mental workload of anaesthetists during simulated practice. British Journal of Anaesthesia,103(5), 665–669. doi:10.1093/bja/aep268.
15. de Jong, T. (2010). Cognitive load theory, educational research, and instructional design: some food for thought. Instructional Science,38(2), 105–105. doi:10.1007/s11251-009-9110-0.
16. DeLeeuw, K. E., & Mayer, R. E. (2008). A comparison of three measures of cognitive load: Evidence for separable measures of intrinsic, extraneous, and germane load. Journal of Educational Psychology,100(1), 223–234. doi:10.1037/0022-0663.100.1.223.
17. Dubrowski, A., Brydges, R., Satterthwaite, L., Xeroulis, G., & Classen, R. (2012). Do not teach me while I am working! American Journal of Surgery,203(2), 253–257. doi:10.1016/j.amjsurg.2010.08.020.
18. Ericsson, K. A. (2004). Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic Medicine,79(10), S70–S81.
19. Eysink, T. H. S., de Jong, T., Berthold, K., Kolloffel, B., Opfermann, M., & Wouters, P. (2009). Learner performance in multimedia learning arrangements: An analysis across instructional approaches. American Educational Research Journal,46(4), 1107–1149. doi:10.3102/0002831209340235.
20. Fitts, P., & Posner, M. I. (1967). Human performance. Oxford: Brooks/Cole.
21. Fraser, K., Ma, I., Teteris, E., Baxter, H., Wright, B., & McLaughlin, K. (2012). Emotion, cognitive load and learning outcomes during simulation training. Medical Education,46(11), 1055–1062. doi:10.1111/j.1365-2923.2012.04355.x.
22. Gurusamy, K., Aggarwal, R., Palanivelu, L., & Davidson, B. R. (2008). Systematic review of randomized controlled trials on the effectiveness of virtual reality training for laparoscopic surgery. The British journal of surgery,95(9), 1088–1097. doi:10.1002/bjs.6344.
23. Haji, F. A., Hoppe, D. J., Morin, M.-P., Giannoulakis, K., Koh, J., Rojas, D., & Cheung, J. J. H. (2014). What we call what we do affects how we do it: A new nomenclature for simulation research in medical education. Advances in health sciences education: theory and practice,19(2), 273–280. doi:10.1007/s10459-013-9452-x.
24. Issenberg, S. B., Ringsted, C., Østergaard, D., & Dieckmann, P. (2011). Setting a research agenda for simulation-based healthcare education. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare,6(3), 155–167. doi:10.1097/SIH.0b013e3182207c24.
25. Jowett, N., Leblanc, V., Xeroulis, G., MacRae, H., & Dubrowski, A. (2007). Surgical skill acquisition with self-directed practice using computer-based video training. The American Journal of Surgery,193(2), 237–242. doi:10.1016/j.amjsurg.2006.11.003.
26. Just, M. A., Carpenter, P. A., Keller, T. A., Emery, L., Zajac, H., & Thulborn, K. R. (2001). Interdependence of nonoverlapping cortical systems in dual cognitive tasks. NeuroImage,14(2), 417–426. doi:10.1006/nimg.2001.0826.
27. Kalyuga, S. (2011). Cognitive load theory: How many types of load does it really need? Educational Psychology Review,23(1), 1–19.
28. Kurahashi, A. M., Harvey, A., MacRae, H., Moulton, C.-A., & Dubrowski, A. (2011). Technical skill training improves the ability to learn. Surgery,149(1), 1–6. doi:10.1016/j.surg.2010.03.006.
29. Leppink, J., Paas, F., van der Vleuten, C. P. M., Van Gog, T., & van Merrienboer, J. J. G. (2013). Development of an instrument for measuring different types of cognitive load. Behavior Research Methods (Print Edition),45(4), 1058–1072. doi:10.3758/s13428-013-0334-1.
30. Magill, R. A. (2004). Motor learning and control. New York, NY: McGraw-Hill.
31. McGaghie, W. C., Issenberg, S. B., Cohen, E. R., Barsuk, J. H., & Wayne, D. B. (2011). Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Academic Medicine,86(6), 706–711. doi:10.1097/ACM.0b013e318217e119.
32. Miller, G. A. (1956). The magical number seven plus or minus two: Some limits on our capacity for processing information. Psychological Review,63(2), 81–97.
33. Nestel, D. D., Groom, J. J., Eikeland-Husebø, S. S., & O’Donnell, J. M. J. (2011). Simulation for learning and teaching procedural skills: The state of the science. Simulation in Healthcare,6(7), S10–S13.
34. Norman, G. R., & Streiner, D. L. (2008). Biostatistics (3rd ed.). Shelton, CT: People’s Medical Publishing House.
35. Paas, F. G. (1992). Training strategies for attaining transfer of problem-solving skill in statistics: A cognitive-load approach. Journal of Educational Psychology,84(4), 429.
36. Paas, F., Renkl, A., & Sweller, J. (2003a). Cognitive load theory and instructional design: Recent developments. Educational Psychologist,38(1), 1–4. doi:10.1207/S15326985EP3801_1.
37. Paas, F., Tuovinen, J. E., Tabbers, H., & Van Gerven, P. W. M. (2003b). Cognitive load measurement as a means to advance cognitive load theory. Educational Psychologist,38(1), 63–71. doi:10.1207/S15326985EP3801_8.
38. Paas, F. G., & van Merrienboer, J. (1994). Variability of worked examples and transfer of geometrical problem-solving skills: A cognitive-load approach. Journal of Educational Psychology,86(1), 122–133.
39. Paas, F. G., Van Merriënboer, J. J., & Adam, J. J. (1994). Measurement of cognitive load in instructional research. Perceptual and Motor Skills,79(1 Pt 2), 419–430.
40. Porte, M. C., Xeroulis, G., Reznick, R. K., & Dubrowski, A. (2007). Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills. The American Journal of Surgery,193(1), 105–110. doi:10.1016/j.amjsurg.2006.03.016.
41. Rojas, D., Haji, F., Shewaga, R., Kapralos, B., & Dubrowski, A. (2014). The impact of secondary-task type on the sensitivity of reaction-time based measurement of cognitive load for novices learning surgical skills using simulation. Studies in health technology and informatics,196, 353–359.
42. Schmidt, R. A., & Lee, T. D. (2005). Motor control and learning (4th ed.). Champaign, IL: Human Kinetics.
43. Shiffrin, R. M., & Schneider, W. (1977). Controlled and automatic human information processing: II. Perceptual learning, automatic attending and a general theory. Psychological Review,84(2), 127–190. doi:10.1037/0033-295X.84.2.127.
44. Sibbald, M., de Bruin, A. B. H., & van Merrienboer, J. J. G. (2013). Checklists improve experts’ diagnostic decisions. Medical Education,47(3), 301–308. doi:10.1111/medu.12080.
45. Stefanidis, D., Scerbo, M. W., Korndorffer, J. R, Jr, & Scott, D. J. (2007). Redefining simulator proficiency using automaticity theory. The American Journal of Surgery,193(4), 502–506. doi:10.1016/j.amjsurg.2006.11.010.
46. Stefanidis, D., Scerbo, M. W., Sechrist, C., Mostafavi, A., & Heniford, B. T. (2008). Do novices display automaticity during simulator training? American Journal of Surgery,195(2), 210–213. doi:10.1016/j.amjsurg.2007.08.055.
47. Sweller, J. (1988). Cognitive load during problem solving: Effects on learning. Cognitive Science,12(2), 257–285. doi:10.1207/s15516709cog1202_4.
48. Sweller, J. (1994). Cognitive load theory, learning difficulty, and instructional design. Learning and Instruction,4, 295–312.
49. Sweller, J., Ayres, P., & Kalyuga, S. (2011). Measuring cognitive load. In Cognitive Load (Ed.), Theory: Explorations in the learning sciences, instructional systems and performance technologies (pp. 71–85). New York, NY: Springer.
50. Sweller, J., van Merrienboer, J. J. G., & Paas, F. G. W. C. (1998). Cognitive architecture and instructional design. Educational Psychology Review,10(3), 251–296. doi:10.1023/A:1022193728205.
51. van Gerven, P. W. M., Paas, F., van Merrienboer, J. J. G., & Schmidt, H. G. (2004). Memory load and the cognitive pupillary response in aging. Psychophysiology,41(2), 167–174. doi:10.1111/j.1469-8986.2003.00148.x.
52. van Merriënboer, J. J. G., & Sweller, J. (2010). Cognitive load theory in health professional education: Design principles and strategies. Medical Education,44(1), 85–93. doi:10.1111/j.1365-2923.2009.03498.x.
53. Xeroulis, G., Park, J., Moulton, C., Reznick, R., Leblanc, V., & Dubrowski, A. (2007). Teaching suturing and knot-tying skills to medical students: A randomized controlled study comparing computer-based video instruction and (concurrent and summary) expert feedback. Surgery,141(4), 442–449. doi:10.1016/j.surg.2006.09.012.
54. Young, J. Q., Van Merrienboer, J., Durning, S., & Cate Ten, O. (2014). Cognitive load theory: Implications for medical education: AMEE Guide No. 86. Medical Teacher,36(5), 371–384. doi:10.3109/0142159X.2014.889290.