Thread by @Megan_EL_Brown

Hello #MedEd #TheoryThursdays!

Have you ever felt frustrated that you weren’t taking in information quick enough? That you brain was maxed out?

Me too! (Isn’t this experience basically medical school??)

Well, then I have a theory for you…

COGNITIVE LOAD THEORY

Cognitive load is the total information-processing demands required by a task/set of tasks. It’s about cognitive capacity – how much information learners can handle before becoming maxed out. Cognitive load theory implied that we have a limited capacity to process new info.

Cognitive load theory is based on how the proponents of this theory say the brain works. The brain has complex memory systems – sensory, working, and long-term memory.

Working memory can only process limited info at any one time.

Cognitive load theory offers guidance on how to help learners process (encode + retrieve) info from working to long term memory and back again

Working -->long term is important for storing info
Long term -->working is important for making sense of new info using past experience

The theory has roots in Miller’s 1956 paper ‘the magical number seven’. He thought we could only process 7 (+/- 2) items in our short-term memory – recent research has lowered this to 4. In the 80s Sweller used research on information processing to create cognitive load theory

There are 3 types of cognitive load:

1.Intrinsic
2.Extraneous
3.Germane

INTRINSIC LOAD – this is the inherent difficulty of a task for a particular learner. This can be influenced by prior knowledge of a topic. How many new things does a learner have to do at once to complete a task?

EXTRANEOUS LOAD – this is the additional avoidable load imposed on a learner by instructional materials (especially if they are poorly designed with confusing fonts, colours, jargon etc.) or busy learning environments (think teaching on a busy ward round).

GERMANE LOAD – sometimes called “generative load”.

This is the mental effort directed towards **integrating** new knowledge with existing knowledge. It is involved in creating, retrieving + using *schemas*.

If a student is too stretched = cognitive overload. Overloaded students don’t have sufficient attention/resources to complete tasks effectively.

If a student isn’t stretched enough = cognitive underload. Doing the same thing over and over again leads to bored learners.

The skill of educators is to include the appropriate amount of content + to create tasks that extend student learning but do not overload, i.e., using scaffolding to support

We need to manage intrinsic load and reduce extraneous load, to increase the space for germane load

Because it is when students make connections between prior + new knowledge that learning happens (i.e. when they digest new knowledge in relation to knowledge already organised in their long-term memory).

Simple ideas become increasingly more complex and nuanced this way

An example of this within Med Ed is how we teach med students to develop “illness scripts”.

"Boring bits":

- Mid-range theory– connects sensory input with memory + knowledge/skills
- Ontology– realism
- Epistemology – knowledge is created at individual level but mechanism of creating + storing knowledge is universal

Usually used within a post-positivist paradigm

There are many many many strategies educators can employ to manage cognitive load. This is a popular theory – there’s lots on it in the literature both within Med Ed, and educational psychology.

Here are some common strategies that can inform our practice as educators:

There is evidence in both psychology + med ed that learning tends to be more effective when it is designed with cognitive load theory in mind.

Some strategies of managing cognitive load are more evidence-based than others (worked examples is supported by lots of research)

However– there is an important limitation to research on cognitive load. Most studies don’t measure load directly – they focus on the effectiveness of instruction designed with cognitive load in mind (e.g. they measure exam performance, or perceived load using rating scales)

Some have tried to measure cognitive load using measures like heart rate + eye activity. Others have intentionally overloaded participants + use impaired task performance as a measure of load.

However, there is a lack of reliable measures of different types of cognitive load.

A further note on limitations from me (your fave interpretivist) – mostly, cognitive load theory studies don’t consider how individual differences between learners might influence cognitive load (with the exception of differences in expertise).

There’s also little literature on how factors other than cognitive load (like learner motivation, beliefs) might influence learning effectiveness using this model. Focusing on germane load + its influences might help address this critique. Scope for future research, perhaps…

Despite current limitations, it’s a useful theory, especially for instructional design + because we have evidence (regardless of the specifics of measurements/ inattention to individual needs) that when sessions are designed using cognitive load theory performance is enhanced:

… but we need to review what people are measuring when they make claims about cognitive load carefully, and not forget about individual differences + context when researching learning.

Because there is SO MUCH cognitive load theory research in med ed, I’m linking to some foundational papers for those who want to know more.

These are really useful overviews of work in this area, which I used when bringing this thread together.

Check them out:

Ok, I am officially overloaded (see what I did there) but this only scratches the surface – it's more of a brief foray into cognitive load theory than an all-inclusive

Next week (inspired by a recent collaboration with @RiyaEGeorge): CRITICAL CONSCIOUSNESS

Stay sweet, Parakeet