The cognitive impact of interactive design features for learning complex materials in medical education

Abstract

To identify the most effective way for medical students to interact with a browser-based learning module on the symptoms and neurological underpinnings of stroke syndromes, this study manipulated the way in which subjects interacted with a graphical model of the brain and examined the impact of functional changes on learning outcomes. It was hypothesized that behavioral interactions that were behaviorally more engaging and which required deeper consideration of the model would result in heightened cognitive interaction and better learning than those whose manipulation required less deliberate behavioral and cognitive processing. One hundred forty four students were randomly assigned to four conditions whose model controls incorporated features that required different levels of behavioral and cognitive interaction: Movie (low behavioral/low cognitive, n = 40), Slider (high behavioral/low cognitive, n = 36), Click (low behavioral/high cognitive, n = 30), and Drag (high behavioral/high cognitive, n = 38). Analysis of Covariates (ANCOVA) showed that students who received the treatments associated with lower cognitive interactivity (Movie and Slider) performed better on a transfer task than those receiving the module associated with high cognitive interactivity (Click and Drag, partial eta squared = .03). In addition, the students in the high cognitive interactivity conditions spent significantly more time on the stroke locator activity than other conditions (partial eta squared = .36). The results suggest that interaction with controls that were tightly coupled with the model and whose manipulation required deliberate consideration of the model’s features may have overtaxed subjects’ cognitive resources. Cognitive effort that facilitated manipulation of content, though directed at the model, may have resulted in extraneous cognitive load, impeding subjects in recognizing the deeper, global relationships in the materials. Instructional designers must, therefore, keep in mind that the way in which functional affordances are integrated with the content can shape both behavioral and cognitive processing, and has significant cognitive load implications.

Subjective cognitive load surveys lead to divergent results for interactive learning media

“…These elements range from basic user controls that allow an influence over the presentation of instructional slides (e.g., Tabbers & de Koeijer, 2010) to immersive digitally‐enhanced environments (e.g., Johnson‐Glenberg, Megowan‐Romanowicz, Birchfield, & Savio‐Ramos, 2016). However, the literature on interactivity also contains negative results, as there are instances in which more static forms of learning media have resulted in better learning performance than versions that incorporated features such as user controls or related forms of responsive interfaces (e.g., Song et al, 2014). Results such as these have been explained in reference to an assumed cognitive overload (e.g., Skulmowski, Pradel, Kühnert, Brunnett, & Rey, 2016).…”

Instructional Strategy: Didactic Media Presentation to Optimize Student Learning

“…The influence spatial proximity has on learning was explored in multiple studies. 12,[15][16][17][18][19] A study 15 using first-year physical therapy students found that by physically integrating written text into figures there was a significant reduction in mental effort and improved retention of information compared to traditional photographs with written text referring to them. Consequently, when students are required to search for segments of written text and labels for pictures, a spilt-attention effect occurs, which increases cognitive load.…”

“…These results indicate that attention-guided cueing allows for the processing of complex information more effectively by freeing space in working memory. Another study 18 exposed medical students to information on stroke conditions in 4 different formats, all consisting of browser-based learning and differing in level of cognitive and behavioral activity. The formats included observing a video that was learner-paced, sliding a handle below a model to move an embolus, clicking on vascular structures, and dragging the embolus along a path of arteries.…”

Supporting Sensemaking of Complex Objects with Visualizations: Visibility and Complementarity of Interactions

“…In the former case, lack of possibilities can make exploratory activities ineffective and inefficient, even frustrating. In the latter case, some costs might be related to time consumption and increased cognitive demand [28,[31][32][33][34][35], as users might need to spend time testing all available interactions, figuring out their functions and benefits, and remembering how and when to use them. The challenge of designing complementary interactions is to balance the need to provide interactions that are conjunctively supportive, yet do not impose additional unintended load on users.…”