Cognitive load theory for training health professionals in the workplace: A BEME review of studies among diverse professions: BEME Guide No. 53

Medical Teacher

Volumn 41, Issue 3, 2019, Pages 256-270

  Sewell, Justin L ^a   Maggio, Lauren A ^b   ten Cate, Olle ^a,c   van Gog, Tamara ^d   Young, John Q ^e   O’Sullivan, Patricia S ^a  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b Uniformed Services University of the Health Sciences   (United States)

^c UNIVERSITY MEDICAL CENTER UTRECHT   (Netherlands)

^d UTRECHT UNIVERSITY   (Netherlands)

^e DONALD AND BARBARA ZUCKER SCHOOL OF MEDICINE AT HOFSTRA NORTHWELL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HUMAN; HUMAN EXPERIMENT; LEARNING ENVIRONMENT; METACOGNITION; OCCUPATION; SCIENTIST; SIMULATION; SYSTEMATIC REVIEW; TEACHING; THEORETICAL STUDY; WORKLOAD; WORKPLACE; CLINICAL COMPETENCE; COGNITION; EDUCATION; HEALTH CARE PERSONNEL; IN SERVICE TRAINING; MEDICAL PROFESSION; ORGANIZATION AND MANAGEMENT;

CLINICAL COMPETENCE; COGNITION; HEALTH OCCUPATIONS; HEALTH PERSONNEL; HUMANS; INSERVICE TRAINING; WORKPLACE;

EID: 85055249134     PISSN: 0142159X     EISSN: 1466187X     Source Type: Journal    
DOI: 10.1080/0142159X.2018.1505034     Document Type: Article

References (126)

1. Andersen SA, Konge L, Caye-Thomasen P, Sorensen MS. 2016. Retention of mastoidectomy skills after virtual reality simulation training. JAMA Otolaryngol Head Neck Surg. 142:635–640.
2. Andersen SA, Mikkelsen PT, Konge L, Cayé-Thomasen P, Sørensen MS. 2016a. Cognitive load in mastoidectomy skills training: virtual reality simulation and traditional dissection compared. J Surg Educ. 73:45–50.
3. Andersen SA, Mikkelsen PT, Konge L, Caye-Thomasen P, Sørensen MS. 2016b. Cognitive load in distributed and massed practice in virtual reality mastoidectomy simulation. Laryngoscope. 126:E74–E79.
4. Arico P, Borghini G, Di Flumeri G, Colosimo A, Bonelli S, Golfetti A, Pozzi S, Imbert JP, Granger G, Benhacene R. 2016. Adaptive automation triggered by EEG-based mental workload index: a passive brain-computer interface application in realistic air traffic control environment. Front Hum Neurosci. 10:539.
5. Arksey H, O'Malley L. 2005. Scoping studies: towards a methodological framework. Int J Soc Res Method. 8:19–32.
6. Attrill S, Lincoln M, McAllister S. 2016. Supervising international students in clinical placements: perceptions of experiences and factors influencing competency development. BMC Med Educ. 16:180
7. Avansino J, Leu MG. 2012. Effects of CPOE on provider cognitive workload: a randomized crossover trial. Pediatrics. 130:e547–e552.
8. Bannert M. 2002. Managing cognitive load–recent trends in cognitive load theory. Commentary. Learn Instr. 12:139–146.
9. Bertram DA, Hershey CO, Opila DA, Quirin O. 1990. A measure of physician mental work load in internal medicine ambulatory care clinics. Med Care. 28:458–467.
10. Bertram DA, Opila DA, Brown JL, Gallagher SJ, Schifeling RW, Snow IS, Hershey CO. 1992. Measuring physician mental workload: reliability and validity assessment of a brief instrument. Med Care. 30:95–104.
11. Bharathan R, Vali S, Setchell T, Miskry T, Darzi A, Aggarwal R. 2013. Psychomotor skills and cognitive load training on a virtual reality laparoscopic simulator for tubal surgery is effective. Eur J Obstet Gynecol Reprod Biol. 169:347–352.
12. Boet S, Sharma B, Pigford AA, Hladkowicz E, Rittenhouse N, Grantcharov T. 2017. Debriefing decreases mental workload in surgical crisis: a randomized controlled trial. Surgery. 161:1215–1220.
13. Britt RC, Scerbo MW, Montano M, Kennedy RA, Prytz E, Stefanidis D. 2015. Intracorporeal suturing: transfer from fundamentals of laparoscopic surgery to cadavers results in substantial increase in mental workload. Surgery. 158:1428–1433.
14. Broyles TW, Epler CM, Waknine JW. 2011. A case study examining the impact of cognitive load on reflection and pre-service teachers' transfer of specific teaching behaviors. Career and Technical Education Research. 36:49–66.
15. Camp G, Paas F, Rikers R, van Merrienboer J. 2001. Dynamic problem selection in air traffic control training: A comparison between performance, mental effort and mental efficiency. Comp Hum Behav. 17:575–595.
16. Chen HC, O’Sullivan P, Teherani A, Fogh S, Kobashi B, ten Cate O. 2015. Sequencing learning experiences to engage different level learners in the workplace: An interview study with excellent clinical teachers. Med Teach. 37:1090–1097.
17. Chen R, Grierson L, Norman G. 2015a. Manipulation of cognitive load variables and impact on auscultation test performance. Adv Health Sci Educ Theory Pract. 20:935–952.
18. Chen R, Grierson LE, Norman GR. 2015b. Evaluating the impact of high- and low-fidelity instruction in the development of auscultation skills. Med Educ. 49:276–285.
19. Cook DA, Castillo RM, Gas B, Artino AR, Jr.2017. Measuring achievement goal motivation, mindsets and cognitive load: validation of three instruments' scores. Med Educ. 51:1061–1074.
20. Corbalan G, Kester L, van Merriënboer JJG. 2008. Selecting learning tasks: effects of adaptation and shared control on learning efficiency and task involvement. Contemp Educ Psychol. 33:733–756.
21. Crosby JJ, Parkinson SR. 1979. A dual task investigation of pilots' skill level. Ergonomics. 22:1301–1313.
22. Cummings ML, Smith CA. 2009. Improving precision vertical flight operations through a direct-perception-action display. J Aircraft. 46:1270–1279.
23. Dahlstrom N, Nahlinder S. 2009. Mental workload in aircraft and simulator during basic civil aviation training. Int J Aviat Psychol. 19:309–325.
24. Dankbaar ME, Alsma J, Jansen EE, van Merrienboer JJ, van Saase JL, Schuit SC. 2016. An experimental study on the effects of a simulation game on students' clinical cognitive skills and motivation. Adv Health Sci Educ Theory Pract. 21:505–521.
25. Davis DHJ, Oliver M, Byrne AJ. 2009. A novel method of measuring the mental workload of anaesthetists during simulated practice. Br J Anaesth. 103:665–669.
26. Di Stasi LL, Díaz-Piedra C, Ruiz-Rabelo JF, Rieiro H, Sanchez Carrion JM, Catena A. 2017. Quantifying the cognitive cost of laparo-endoscopic single-site surgeries: Gaze-based indices. Appl Ergon. 65:168–174.
27. Doig AK, Albert RW, Syroid ND, Moon S, Agutter JA. 2011. Graphical arterial blood gas visualization tool supports rapid and accurate data interpretation. Comput Inform Nurs. 29:204–260.
28. Dominessy ME, Lukas JH, Malkin FJ, Monty RA, Oatman LC. 1991. The effect of information display formats on helicopter pilots' target acquisition and flying performance. Mil Psychol. 3:163–176.
29. Donato AA, Kaliyadan AG, Wasser T. 2014. Self-directed study using MP3 players to improve auscultation proficiency of physicians: a randomized, controlled trial. J Contin Educ Health Prof. 34:131–138.
30. Durning S, Artino AR, Jr., Pangaro L, van der Vleuten CP, Schuwirth L. 2011. Context and clinical reasoning: understanding the perspective of the expert's voice. Med Educ. 45:927–938.
31. Durning SJ, Artino AR, Boulet JR, Dorrance K, van der Vleuten C, Schuwirth L. 2012. The impact of selected contextual factors on experts' clinical reasoning performance (does context impact clinical reasoning performance in experts?) Adv Health Sci Educ Theory Pract. 17:65–79.
32. Ericsson KA. 2004. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 79:S70–S81.
33. Feldon DF. 2007. Cognitive load and classroom teaching: the double-edged sword of automaticity. Educ Psych. 42:123–137.
34. Fiorella L, Mayer RE. 2016. Eight ways to promote generative learning. Educ Psychol Rev. 28:717–741.
35. Fraser K, Huffman J, Ma I, Sobczak M, McIlwrick J, Wright B, McLaughlin K. 2014. The emotional and cognitive impact of unexpected simulated patient death: a randomized controlled trial. Chest. 145:958–963.
36. Fraser K, Ma I, Teteris E, Baxter H, Wright B, McLaughlin K. 2012. Emotion, cognitive load and learning outcomes during simulation training. Med Educ. 46:1055–1062.
37. Fraser KL, Ayres P, Sweller J. 2015. Cognitive load theory for the design of medical simulations. Simul Healthc. 10:295–307.
38. Gaba DM, Lee T. 1990. Measuring the workload of the anesthesiologist. Anesth Analg. 71:354–361.
39. Gardner AK, Clanton J, Jabbour II, Scott L, Scott DJ, Russo MA. 2016. Impact of seductive details on the acquisition and transfer of laparoscopic suturing skills: emotionally interesting or cognitively taxing? Surgery. 160:580–585.
40. Gruppen L, Frank JR, Lockyer J, Ross S, Bould MD, Harris P, Bhanji F, Hodges BD, Snell L, Ten Cate O. 2017. Toward a research agenda for competency-based medical education. Med Teach. 39:623–630.
41. Guru KA, Esfahani ET, Raza SJ, Bhat R, Wang K, Hammond Y, Wilding G, Peabody JO, Chowriappa AJ. 2015. Cognitive skills assessment during robot-assisted surgery: separating the wheat from the chaff. BJU Int. 115:166–174.
42. Haji FA, Cheung JJ, Woods N, Regehr G, de Ribaupierre S, Dubrowski A. 2016. Thrive or overload? The effect of task complexity on novices' simulation-based learning. Med Educ. 50:955–968.
43. Haji FA, Khan R, Regehr G, Drake J, de Ribaupierre S, Dubrowski A. 2015. Measuring cognitive load during simulation-based psychomotor skills training: sensitivity of secondary-task performance and subjective ratings. Adv Health Sci Educ Theory Pract. 20:1237–1253.
44. Haji FA, Rojas D, Childs R, Ribaupierre S, Dubrowski A. 2015. Measuring cognitive load: performance, mental effort and simulation task complexity. Med Educ. 49:815–827.
45. Hanham J, Leahy W, Sweller J. 2017. Cognitive load theory, element interactivity, and the testing and reverse testing effects. Appl Cognit Psychol. 31:265–280.
46. Hautz WE, Schroder T, Dannenberg KA, Marz M, Holzer H, Ahlers O, Thomas A. 2017. Shame in medical education: a randomized study of the acquisition of intimate examination skills and its effect on subsequent performance. Teach Learn Med. 29:196–206.
47. Hsieh MH, Hwang SL, Liu KH, Liang SFM, Chuang CF. 2012. A decision support system for identifying abnormal operating procedures in a nuclear power plant. Nucl Eng Des. 249:413–418.
48. Hsu CK, Lin SC, Li WC. 2015. Visual movement and mental-workload for pilot performance assessment. Lect Notes Comput Sci. 9174:356–364.
49. Hussein AA, Shafiei SB, Sharif M, Esfahani E, Ahmad B, Kozlowski JD, Hashmi Z, Guru KA. 2016. Technical mentorship during robot-assisted surgery: a cognitive analysis? BJU Int. 118:429–436.
50. Illeris K. 2009. Contemporary theories of learning. New York, NY: Routledge.
51. Kalyuga S. 2011. Cognitive load theory: how many types of load does it really need? Educ Psychol Rev. 23:1–19.
52. Kalyuga S, Ayres P, Chandler P, Sweller J. 2003. The expertise reversal effect. Educational Psychologist. 38:23–31.
53. Kataoka J, Sasaki M, Kanda K. 2011. Effects of mental workload on nurses' visual behaviors during infusion pump operation. Jpn J Nurs Sci. 8:47–56.
54. Khalil MK, Paas F, Johnson TE, Su YK, Payer AF. 2008. Effects of instructional strategies using cross sections on the recognition of anatomical structures in correlated CT and MR images. Anat Sci Ed. 1:75–83.
55. Kostons D, van Gog T, Paas F. 2012. Training self-assessment and task-selection skills: a cognitive approach to improving self-regulated learning. Learn Instr. 22:121–132.
56. Kumasi KD, Charbonneau DH, Walster D. 2013. Theory talk in the library science scholarly literature: an exploratory analysis. Lib Inf Sci Res. 35:175–180.
57. Lane IF. 2010. Professional competencies in health sciences education: from multiple intelligences to the clinic floor. Adv Health Sci Educ Theory Pract. 15:129–146.
58. Lee GI, Lee MR. 2018. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads. Surg Endosc. 32:62–72.
59. Lee GI, Lee MR, Clanton T, Clanton T, Sutton E, Park AE, Marohn MR. 2014. Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries. Surg Endosc. 28:456–465.
60. Lee MH, Schemmel AJ, Pooler BD, Hanley T, Kennedy T, Field A, Wiegmann D, Yu JJ. 2017. Radiology workflow dynamics: how workflow patterns impact radiologist perceptions of workplace satisfaction. Acad Radiol. 24:483–487.
61. Leppink J, Duvivier R. 2016. Twelve tips for medical curriculum design from a cognitive load theory perspective. Med Teach. 38:669–674.
62. Leppink J, Paas F, Van der Vleuten CP, Van Gog T, Van MJJ. 2013. Development of an instrument for measuring different types of cognitive load. Behav Res Methods. 45:1058–1072.
63. Leppink J, van den Heuvel A. 2015. The evolution of cognitive load theory and its application to medical education. Perspect Med Educ. 4:119–127.
64. Liang GF, Lin JT, Hwang SL, Wang EM, Patterson P. 2010. Preventing human errors in aviation maintenance using an on-line maintenance assistance platform. Int J Ind Ergon. 40:356–367.
65. Lucey CR, Thibault GE, Ten Cate O. 2018. Competency-based, time-variable education in the health professions: crossroads. Acad Med. 93:S1–S5.
66. Maxwell D, Zheng J. 2017. Large scale testing and evaluation of virtual environments for infantry soldier tasks comparing mental effort for live versus virtual training performance assessments. Virginia Beach, VA: MODSIM World 2017.
67. Mayer RE. 2009. Multimedia learning. 2nd ed. New York, NY: Cambridge University Press.
68. Mihalca L, Salden RJCM, Corbalan G, Paas F, Miclea M. 2011. Effectiveness of cognitive-load based adaptive instruction in genetics education. Comp Hum Behav. 27:82–88.
69. Miskovic D, Rosenthal R, Zingg U, Oertli D, Metzger U, Jancke L. 2008. Randomized controlled trial investigating the effect of music on the virtual reality laparoscopic learning performance of novice surgeons. Surg Endosc. 22:2416–2420.
70. Modi H, Leff D, Singh H, Darzi A. 2016. The influence of cognitive load on technical ability among surgical trainees. Int J Surg. 36:S34–S35.
71. Mohamed R, Raman M, Anderson J, McLaughlin K, Rostom A, Coderre S. 2014. Validation of the national aeronautics and space administration task load index as a tool to evaluate the learning curve for endoscopy training. Can J Gastroenterol Hepatol. 28:155–159.
72. Montero PN, Acker CE, Heniford BT, Stefanidis D. 2011. Single incision laparoscopic surgery (SILS) is associated with poorer performance and increased surgeon workload compared with standard laparoscopy. Am Surg. 77:73–77.
73. Moore LJ, Wilson MR, McGrath JS, Waine E, Masters RSW, Vine SJ. 2015. Surgeons’ display reduced mental effort and workload while performing robotically assisted surgical tasks, when compared to conventional laparoscopy. Surg Endosc. 29:2553–2560.
74. Moos DC, Pitton D. 2014. Student teacher challenges: using the cognitive load theory as an explanatory lens. Teaching Education. 25:127–141.
75. Moreno R. 2010. Cognitive load theory: more food for thought. Instr Sci. 38:135–141.
76. Moris DN, Linos D. 2013. Music meets surgery: two sides to the art of "healing". Surg Endosc. 27:719–723.
77. Morris CH, Leung YK. 2006. Pilot mental workload: how well do pilots really perform? Ergonomics. 49:1581–1596.
78. Mouraviev V, Klein M, Schommer E, Thiel DD, Samavedi S, Kumar A, Leveillee RJ, Thomas R, Pow-Sang JM, Su L-M, et al. 2016. Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules. J Robot Surg. 10:49–56.
79. Murai K, Ishikura A, Hayashi Y, Matsumoto T, Kuramoto K, Higuchi K, Saiki T, Fujita T, Maenaka K. 2010. Toward evaluation of ship bridge teamwork for marine simulator training based on heart rate variability. Kobe, Japan: World Automation Congress.
80. Naismith LM, Cavalcanti RB. 2015. Validity of cognitive load measures in simulation-based training: a systematic review. Acad Med. 90:S24–S35.
81. Naismith LM, Cheung JJH, Ringsted C, Cavalcanti RB. 2015. Limitations of subjective cognitive load measures in simulation-based procedural training. Med Educ. 49:805–814.
82. Paas F, Tuovinen JE, Tabbers H, Van Gerven PWM. 2003. Cognitive load measurement as a means to advance cognitive load theory. Educ Psychol.38:63–71.
83. Qiao YQ, Shen J, Liang X, Ding S, Chen FY, Shao L, Zheng Q, Ran ZH. 2014. Using cognitive theory to facilitate medical education. BMC Med Educ. 14:79.
84. Rasmussen SR, Konge L, Mikkelsen PT, Sørensen MS, Andersen SAW. 2016. Notes from the field: secondary task precision for cognitive load estimation during virtual reality surgical simulation training. Eval Health Prof. 39:114–120.
85. Rop G, Wermeskerken M, Nooijer JA, Verkoeijen PPJL, Gog T. 2018. Task experience as a boundary condition for the negative effects of irrelevant information on learning. Educ Psychol Rev. 30:229–253.
86. Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. 2016. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 316:2214–2236.
87. Saleem JJ, Patterson ES, Militello L, Anders S, Falciglia M, Wissman JA, Roth EM, Asch SM. 2007. Impact of clinical reminder redesign on learnability, efficiency, usability, and workload for ambulatory clinic nurses. J Am Med Inform Assoc. 14:632–640.
88. Saus E, Johnsen BH, Eid J. 2010. Perceived learning outcome: the relationship between experience, realism and situation awareness during simulator training. Int Marit Health. 62:258–264.
89. Saus E, Johnsen BH, Eid J, Riisem PK, Andersen R, Thayer JF. 2006. The effect of brief situational awareness training in a police shooting simulator: an experimental study. Mil Psychol. 18:S3–S21.
90. Sawyer T, White M, Zaveri P, Chang T, Ades A, French H, Anderson J, Auerbach M, Johnston L, Kessler D. 2015. Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine. Acad Med. 90:1025–1033.
91. Scerbo MW, Britt RC, Stefanidis D. 2017. Differences in mental workload between traditional and single-incision laparoscopic procedures measured with a secondary task. Am J Surg. 213:244–248.
92. Sewell JL, Boscardin CK, Young JQ, ten Cate O, O'Sullivan PS. 2016. Measuring cognitive load during procedural skills training with colonoscopy as an exemplar. Med Educ. 50:682–692.
93. Sewell JL, Boscardin CK, Young JQ, ten Cate O, O’Sullivan PS. 2017. Learner, patient, and supervisor features are associated with different types of cognitive load during procedural skills training: implications for teaching and instructional design. Acad Med. 92:1622–1631.
94. Sweller J, Ayres J, Kalyuga S. 2011. Cognitive load theory. New York (NY): Springer.
95. Sexton K, Johnson A, Gotsch A, Hussein AA, Cavuoto L, Guru KA. 2018. Anticipation, teamwork and cognitive load: chasing efficiency during robot-assisted surgery. BMJ Qual Saf. 27:148–154.
96. Shachak A, Hadas-Dayagi M, Ziv A, Reis S. 2009. Primary care physicians' use of an electronic medical record system: a cognitive task analysis. J Gen Intern Med. 24:341–348.
97. Shewokis PA, Shariff FU, Liu Y, Ayaz H, Castellanos A, Lind DS. 2017. Acquisition, retention and transfer of simulated laparoscopic tasks using fNIR and a contextual interference paradigm. Am J Surg. 213:336–345.
98. Sibbald M, de Bruin AB, Cavalcanti RB, van Merrienboer JJG. 2013. Do you have to re-examine to reconsider your diagnosis? Checklists and cardiac exam. BMJ Qual Saf. 22:333–338.
99. Sibbald M, de Bruin ABH, van Merrienboer JJG. 2013. Checklists improve experts' diagnostic decisions. Med Educ. 47:301–308.
100. Siu KC, Suh IH, Mukherjee M, Oleynikov D, Stergiou N. 2010. The effect of music on robot-assisted laparoscopic surgical performance. Surg Innov. 17:306–311.
101. Stefanidis D, Wang F, Korndorffer JR, Jr., Dunne JB, Scott DJ. 2010. Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc. 24:377–382.
102. Sweller J. 1988. Cognitive load during problem solving: effects on learning. Cogn Sci. 12:257–285.
103. Szulewski A, Roth N, Howes D. 2015. The use of task-evoked pupillary response as an objective measure of cognitive load in novices and trained physicians: a new tool for the assessment of expertise. Acad Med. 90:981–987.
104. Thistlethwaite J, Hammick M. 2010. The Best Evidence Medical Education (BEME) Collaboration: into the next decade. Med Teach. 32:880–882.
105. Thomas L, Donohue-Porter P, Stein Fishbein J. 2017. Impact of interruptions, distractions, and cognitive load on procedure failures and medication administration errors. J Nurs Care Qual. 32:309–317.
106. Toff NJ. 2010. Human factors in anaesthesia: lessons from aviation. Br J Anaesth. 105:21–25.
107. Tomasko JM, Pauli EM, Kunselman AR, Haluck RS. 2012. Sleep deprivation increases cognitive workload during simulated surgical tasks. Am J Surg. 203:37–43.
108. Tremblay ML, Lafleur A, Leppink J, Dolmans DH. 2017. The simulated clinical environment: Cognitive and emotional impact among undergraduates. Med Teach. 39:181–187.
109. van Merrienboer JJ, Sweller J. 2010. Cognitive load theory in health professional education: design principles and strategies. Med Educ. 44:85–93.
110. Vandewaetere M, Manhaeve D, Aertgeerts B, Clarebout G, Van Merrienboer JJ, Roex A. 2015. 4C/ID in medical education: how to design an educational program based on whole-task learning: AMEE Guide No. 93. Med Teach. 37:4–20.
111. Walker J, von Bergmann H. 2015. Lessons from a pilot project in cognitive task analysis: the potential role of intermediates in preclinical teaching in dental education. J Dent Educ. 79:286–294.
112. Weigl M, Antoniadis S, Chiapponi C, Bruns C, Sevdalis N. 2015. The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery. Surg Endosc. 29:145–153.
113. Weigl M, Stefan P, Abhari K, Wucherer P, Fallavollita P, Lazarovici M, Weidert S, Euler E, Catchpole K. 2016. Intra-operative disruptions, surgeon's mental workload, and technical performance in a full-scale simulated procedure. Surg Endosc. 30:559–566.
114. Weinger MB, Vredenburgh AG, Schumann CM, Macario A, Williams KJ, Kalsher MJ, Smith B, Truong PC, Kim A. 2000. Quantitative description of the workload associated with airway management procedures. J Clin Anesth. 12:273–282.
115. Workman M, Lesser MF, Kim J. 2007. An exploratory study of cognitive load in diagnosing patient conditions. Int J Qual Health Care. 19:127–133.
116. Wucherer P, Stefan P, Abhari K, Fallavollita P, Weigl M, Lazarovici M, Winkler A, Weidert S, Peters T, de Ribaupierre S, et al. 2015. Vertebroplasty performance on simulator for 19 surgeons using hierarchical task analysis. IEEE Trans Med Imaging. 34:1730–1737.
117. Young JQ, Boscardin CK, van Dijk SM, Abdullah R, Irby DM, Sewell JL, Ten Cate O, O'Sullivan PS. 2016. Performance of a cognitive load inventory during simulated handoffs: evidence for validity. SAGE Open Med. 4:2050312116682254.
118. Young JQ, Irby DM, Barilla-LaBarca M-L, ten Cate O, O’Sullivan PS. 2016. Measuring cognitive load: mixed results from a handover simulation for medical students. Perspect Med Educ. 5:24–32.
119. Young JQ, Niehaus B, Lieu SC, O’Sullivan PS. 2010. Improving resident education and patient safety: a method to balance initial caseloads at academic year-end transfer. Acad Med. 85:1418–1424.
120. Young JQ, Sewell JL. 2015. Applying cognitive load theory to medical education: construct and measurement challenges. Perspect Med Educ. 4:107–109.
121. Young JQ, Ten Cate O, O'Sullivan PS, Irby DM. 2016. Unpacking the complexity of patient handoffs through the lens of cognitive load theory. Teach Learn Med. 28:88–96.
122. Young JQ, Van Merrienboer J, Durning S, Ten Cate O. 2014. Cognitive load theory: implications for medical education: AMEE Guide No. 86. Med Teach. 36:371–384.
123. Young JQ, Wachter RM, Ten Cate O, O'Sullivan PS, Irby DM. 2016. Advancing the next generation of handover research and practice with cognitive load theory. BMJ Qual Saf. 25:66–70.
124. Zheng B, Cassera MA, Martinec DV, Spaun GO, Swanström LL. 2010. Measuring mental workload during the performance of advanced laparoscopic tasks. Surg Endosc. 24:45–50.
125. Zheng B, Fu B, Al-Tayeb TA, Hao YF, Qayumi AK. 2014. Mastering instruments before operating on a patient: the role of simulation training in tool use skills. Surg Innov. 21:637–642.
126. Zheng B, Rieder E, Cassera MA, Martinec DV, Lee G, Panton ONM, Park A, Swanström LL. 2012. Quantifying mental workloads of surgeons performing natural orifice transluminal endoscopic surgery (NOTES) procedures. Surg Endosc. 26:1352–1358.