Kish International Campus, University of Tehran, Tehran, Iran.
Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
BMC Med Educ. 2024 Jun 18;24(1):678. doi: 10.1186/s12909-024-05664-z.
The present study aimed to test the relationship between the components of the Cognitive Load Theory (CLT) including memory, intrinsic and extraneous cognitive load in workplace-based learning in a clinical setting, and decision-making skills of nursing students.
This study was conducted at Shahid Sadoughi University of Medical Sciences in 2021-2023. The participants were 151 nursing students who studied their apprenticeship courses in the teaching hospitals. The three basic components of the cognitive load model, including working memory, cognitive load, and decision-making as the outcome of learning, were investigated in this study. Wechsler's computerized working memory test was used to evaluate working memory. Cognitive Load Inventory for Handoffs including nine questions in three categories of intrinsic cognitive load, extraneous cognitive load, and germane cognitive load was used. The clinical decision-making skills of the participants were evaluated using a 24-question inventory by Lowry et al. based on a 5-point scale. The path analysis of AMOS 22 software was used to examine the relationships between components and test the model.
In this study, the goodness of fit of the model based on the cognitive load theory was reported (GIF = 0.99, CFI = 0.99, RMSEA = 0.03). The results of regression analysis showed that the scores of decision-making skills in nursing students were significantly related to extraneous cognitive load scores (p-value = 0.0001). Intrinsic cognitive load was significantly different from the point of view of nursing students in different academic years (p = 0.0001).
The present results showed that the CLT in workplace-based learning has a goodness of fit with the components of memory, intrinsic cognitive load, extraneous cognitive load, and clinical decision-making skill as the key learning outcomes in nursing education. The results showed that the relationship between nursing students' decision-making skills and extraneous cognitive load is stronger than its relationship with intrinsic cognitive load and memory Workplace-based learning programs in nursing that aim to improve students' decision-making skills are suggested to manage extraneous cognitive load by incorporating cognitive load principles into the instructional design of clinical education.
本研究旨在检验认知负荷理论（CLT）的组成部分（包括工作记忆、内在认知负荷和外在认知负荷）与临床环境下基于工作场所的学习中学生的决策技能之间的关系。
本研究于 2021 年至 2023 年在沙希德·萨多希医科大学进行。参与者为 151 名在教学医院学习实习课程的护理学生。本研究调查了认知负荷模型的三个基本组成部分，包括工作记忆、认知负荷和学习的结果——决策技能。我们使用韦氏计算机化工作记忆测验来评估工作记忆。认知负荷清单用于交接班，包括内在认知负荷、外在认知负荷和相关认知负荷三个类别的 9 个问题。参与者的临床决策技能使用 Lowry 等人基于 5 分制的 24 题清单进行评估。使用 AMOS 22 软件的路径分析来检验模型之间的关系。
本研究报告了基于认知负荷理论的模型拟合度良好（GIF=0.99，CFI=0.99，RMSEA=0.03）。回归分析的结果表明，护理学生决策技能的得分与外在认知负荷的得分显著相关（p 值=0.0001）。内在认知负荷在不同年级的护理学生中存在显著差异（p=0.0001）。
本研究结果表明，基于工作场所的学习中的认知负荷理论与记忆、内在认知负荷、外在认知负荷和临床决策技能等关键学习成果的组成部分具有良好的拟合度。研究结果表明，护理学生的决策技能与外在认知负荷的关系强于其与内在认知负荷和记忆的关系。建议在护理教育中，采用基于工作场所的学习方案，通过将认知负荷原则纳入临床教育的教学设计来管理外在认知负荷，以提高学生的决策技能。
