Thread by @JenniferSpicer4

For my 1st #MedEd #Tweetorial, I’m going to discuss cognitive load theory and its implications for our teaching in the classroom & clinical setting.

Here’s a great reference for anyone interested in learning more from @AMEE_Online & @MedTeachJournal:
doi.org/10.3109/014215…

@AMEE_Online @MedTeachJournal 1st, a definition:

Cognitive load = the amount of mental energy that it takes to learn new information or perform a task.

Cognitive load theory proposes that we have a limited amount of mental energy available, and optimizing it makes it easier for us to function.

@AMEE_Online @MedTeachJournal Cognitive load theory identifies 3 components of cognitive load:

1. Intrinsic load
2. Extraneous load
3. Germane load

These components can be altered to make a task easier or harder to perform.

@AMEE_Online @MedTeachJournal Intrinsic load = inherent difficulty of the task/topic (i.e. content complexity)

For example, some topics (glomerulonephritis, renal tubular acidosis, immunology, etc) are inherently more difficult to learn – this is at least partially due to their high intrinsic cognitive load.

@AMEE_Online @MedTeachJournal Extraneous load = how the task is presented to the learner (i.e. instructional technique & impact of the surrounding environment)

Examples of high extraneous load include unorganized presentations, bad audiovisual materials, & external distractions (e.g. ambient noise)

@AMEE_Online @MedTeachJournal Germane load = mental energy spent learning the task (i.e. processing & constructing the information)

Germane load isn’t bad. It can be beneficial for learners to struggle to learn material; however, the goal is for learners to create a cognitive schema for future use.

@AMEE_Online @MedTeachJournal In summary, I like to think of it as:

Intrinsic load = WHAT content is being taught

Extraneous load = HOW the INSTRUCTOR is teaching the material

Germane load = HOW the LEARNER is processing the information so that it can be more easily remembered in the future

@AMEE_Online @MedTeachJournal As educators, we often don’t have much control over intrinsic load (some material is just difficult, but necessary, to learn!); however, we can decrease extraneous load and optimize germane load in our teaching.

Let’s discuss some concrete examples of how to do this.

@AMEE_Online @MedTeachJournal Managing intrinsic load may not be possible, but here are things to consider:

1. Simplify material (do they REALLY need to know all those details in your slides?)

2. Modify content based on learner level (don’t use the same slides to teach med students, residents & fellows)

@AMEE_Online @MedTeachJournal Decrease extraneous load by:

1. Creating slides and/or chalk talks with mostly images and minimal words

2. Eliminating material unrelated to learning objectives (e.g. superfluous stories)

3. Reduce distractions (e.g. phones/pagers beeping, side conversations, etc)

@AMEE_Online @MedTeachJournal Optimize germane load by:

1. Provide or have learners create cognitive schemas (shout out @CPSolvers & @DxRxEdu)

2. Have learners apply material to different problems (allows generalization of material)

3. Prompt learners to explain their reasoning

@AMEE_Online @MedTeachJournal @CPSolvers @DxRxEdu Cognitive load theory has been used to describe optimal ways to use multimedia technology (e.g. videos, PowerPoint presentations, etc).

Richard Mayer has written a lot of literature on this topic, and here’s one of his papers:
doi.org/10.1207/S15326…

@AMEE_Online @MedTeachJournal @CPSolvers @DxRxEdu Cognitive load theory can also be applied to other processes in medicine. Here are 2 applications from my course @uicdme w/ @JanetRiddleDME

Patient handoffs:
doi.org/10.1207/S15326…

Procedural skills training:
insights.ovid.com/crossref?an=00…

@AMEE_Online @MedTeachJournal @CPSolvers @DxRxEdu @uicdme @JanetRiddleDME I'd love to get your thoughts.

How have you used cognitive load theory in your teaching or clinical work?

@VarunPhadke2 @gradydoctor @CarlosdelRio7 @Armstrws @ReenaHem @DxRxEdu @BSchwartzinSF @EmilyAbdoler @CPSolvers @karenlawmd @MDdreamchaser @Darcy_ID_doc @DocWoc71

@AMEE_Online @MedTeachJournal @CPSolvers @DxRxEdu @uicdme @JanetRiddleDME @VarunPhadke2 @gradydoctor @CarlosdelRio7 @Armstrws @ReenaHem @BSchwartzinSF @EmilyAbdoler @karenlawmd @MDdreamchaser @Darcy_ID_doc @DocWoc71 And how can you apply principles of cognitive load theory to one of the following:

1. A course you teach
2. Your next lecture
3. Teaching in the clinic
4. Teaching on the wards

I look forward to sharing more from my courses w/ @uicdme @mededdoc @YoonSooPark2 @JanetRiddleDME

Would love to hear thoughts from my other @uicdme classmates - @RoyKhalife89 @Leizl_CAMES @KatieFisherEM @Bhavinddalal - who else is on Twitter from our class?

@HollyGoodMD I meant to tag you too! Would love to hear your thoughts.