technology assisted learning
Emotion, cognitive load and learning outcomes during simulation training
Version of Record online: 18 OCT 2012
© Blackwell Publishing Ltd 2012
Volume 46, Issue 11, pages 1055–1062, November 2012
How to Cite
Fraser, K., Ma, I., Teteris, E., Baxter, H., Wright, B. and McLaughlin, K. (2012), Emotion, cognitive load and learning outcomes during simulation training. Medical Education, 46: 1055–1062. doi: 10.1111/j.1365-2923.2012.04355.x
- Issue online: 18 OCT 2012
- Version of Record online: 18 OCT 2012
- Received 29 February 2012; editorial comments to authors 4 April 2012; accepted for publication 13 June 2012
Medical Education 2012: 46: 1055–1062
CONTEXT Simulation training has emerged as an effective way to complement clinical training of medical students. Yet outcomes from simulation training must be considered suboptimal when 25–30% of students fail to recognise a cardiac murmur on which they were trained 1 hour previously. There are several possible explanations for failure to improve following simulation training, which include the impact of heightened emotions on learning and cognitive overload caused by interactivity with high-fidelity simulators. This study was conducted to assess emotion during simulation training and to explore the relationships between emotion and cognitive load, and diagnostic performance.
METHODS We trained 84 Year 1 medical students on a scenario of chest pain caused by symptomatic aortic stenosis. After training, students were asked to rate their emotional state and cognitive load. We then provided training on a dyspnoea scenario before asking participants to diagnose the murmur in which they had been trained (aortic stenosis) and a novel murmur (mitral regurgitation). We used factor analysis to identify the principal components of emotion, and then studied the associations between these components of emotion and cognitive load and diagnostic performance.
RESULTS We identified two principal components of emotion, which we felt represented invigoration and tranquillity. Both of these were associated with cognitive load with adjusted regression coefficients of 0.63 (95% confidence interval [CI] 0.28–0.99; p = 0.001) and − 0.44 (95% CI − 0.77 to − 0.10; p = 0.009), respectively. We found a significant negative association between cognitive load and the odds of subsequently identifying the trained murmur (odds ratio 0.27, 95% CI 0.11–0.67; p = 0.004).
CONCLUSIONS We found that increased invigoration and reduced tranquillity during simulation training were associated with increased cognitive load, and that the likelihood of correctly identifying a trained murmur declined with increasing cognitive load. Further studies are needed to evaluate the impact on performance of strategies to alter emotion and cognitive load during simulation training.