Evaluation of cognitive load and emotional states during multidisciplinary critical care simulation sessions

Abstract

BackgroundThe simulation in critical care setting involves a heterogeneous group of participants with varied background and experience. Measuring the impacts of simulation on emotional state and cognitive load in this setting is not often performed. The feasibility of such measurement in the critical care setting needs further exploration.MethodsMedical and nursing staff with varying levels of experience from a tertiary intensive care unit participated in a standardised clinical simulation scenario. The emotional state of each participant was assessed before and after completion of the scenario using a validated eight-item scale containing bipolar oppositional descriptors of emotion. The cognitive load of each participant was assessed after the completion of the scenario using a validated subjective rating tool.ResultsA total of 103 medical and nursing staff participated in the study. The participants felt more relaxed (−0.28±1.15 vs 0.14±1, P<0.005; d=0.39), excited (0.25±0.89 vs 0.55±0.92, P<0.005, d=0.35) and alert (0.85±0.87 vs 1.28±0.73, P<0.00001, d=0.54) following simulation. There was no difference in the mean scores for the remaining five items. The mean cognitive load for all participants was 6.67±1.41. There was no significant difference in the cognitive loads among medical staff versus nursing staff (6.61±2.3 vs 6.62±1.7; P>0.05).ConclusionA well-designed complex high fidelity critical care simulation scenario can be evaluated to identify the relative cognitive load of the participants’ experience and their emotional state. The movement of learners emotionally from a more negative state to a positive state suggests that simulation can be an effective tool for improved knowledge transfer and offers more opportunity for dynamic thinking.

Psychometric properties of the Chinese version of the instrument for measuring different types of cognitive load (MDT‐CL)

“…Regarding the test–retest reliability, the extraneous CL was the least stable factor among the three identified factors in the Chinese version MDT‐CL. The possible reason might include the following: (a) there are only three items included in the extraneous CL and Leppink et al (Leppink et al, ) indicated that the stability of a scale or subscale can be affected when there are only few items within a scale or subscale and (b) extraneous CL may vary when the participant's emotions (Pawar et al, ) or the physical environment (Aldekhyl, Cavalcanti, & Naismith, ) is subject to change. Future studies are needed to conduct equivalence reliability for testing the stability of the extraneous CL (Park et al, ).…”

“…However, the correlation between extraneous CL and germane CL (r = 0.003) in our study is different than the original study (r = −0.19). If a nursing care activity is presented to a nurse in a simple or familiar way, and there is a lower extraneous CL, it seems that the nurse may devote more cog- (Pawar et al, 2018) or the physical environment (Aldekhyl, Cavalcanti, & Naismith, 2018) is subject to change.…”

“…resources to perform the work efficiently (Mohammadi, Mazloumi, Kazemi, & Zeraati, 2015;Pawar, Jacques, Deshpande, Pusapati, & Meguerdichian, 2018). Cognitive overloads, which exceeds one's cognitive resource capacity, are often related to lower speed of receiving and processing information, decreased capacity of cognitive resources and poor performance during work (Kirschner, Sweller, Kirschner, & Zambrano, 2018;Vogels, Demberg, & Kray, 2018;Watanabe & Yamauchi, 2018).…”

Translation and psychometric validation of the Chinese version of the Emotional Labour Scale for nurses

“…In terms of test–retest reliability, ‘patient‐focused emotional suppression’ was the least stable of the three factors in the C‐ELS for nurses. This may be due to changes in participants' emotions (Pawar, Jacques, Deshpande, Pusapati, & Meguerdichian, 2018) and external environment (Aldekhyl, Cavalcanti, & Naismith, 2018). Therefore, for stability testing, equivalent reliability testing is also required in further research.…”

Volume Versus Mass Dosing of Epinephrine for Neonatal Resuscitation: A Randomized Trial

“…3 During the stress of a delivery room resuscitation, noise, time pressure, and the use of unfamiliar medications increase the risk of dosing errors. 4,5 Epinephrine is used infrequently during neonatal resuscitation. Timely administration of the correct dose may be lifesaving.…”