Measuring Cognitive Load in a Clinical Setting: Medical Learning and Practice

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Johannessen, Erika
Cognitive Load , Psychometric , Physiologic , Galvanic Skin Response
Cognitive load theory is of particular relevance to the learning and practice of medicine, where task demands require a complex interplay of working memory, emotion, and stress. To better understand the role of cognitive load in the performance of medical learners and expert physicians, this thesis aims to explore the ways in which cognitive load can be measured in a clinical setting using wearable technologies. First, both traditional literature and systematic reviews were conducted to identify the methods by which cognitive load can be measured using psychometric scales, secondary task performance, and physiologic response measures. Several themes emerged from the data extracted from the systematic review that identified key limitations in the cognitive load literature, including a lack of real world studies. An experiment was conducted in the emergency department of an academic medical center to measure the cognitive load of expert trauma physicians during real resuscitation response using a combination of physiologic measures and psychometric scales. Physiologic metrics showed correlation to self-reported cognitive load scores and offer a promising avenue for measuring cognitive load in an ambulatory setting. A second study was conducted in a clinical simulation center to measure the effectiveness of psychological skills training to enhance learning of first year medical residents during simulated resuscitation education. Both physiologic and psychometric outcomes revealed that this technique is effective in lowering cognitive load and that it may be used to enhance learning and performance in stressful situations. In summary, the chapters of this thesis present a detailed overview of cognitive load theory and its founding literature, describe the biophysical and engineering principles involved in its measurement, and demonstrate the successful real-world application of these concepts to medical learning and practice.
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