The Cognitive Load of Inpatient Consults: Development of the Consult Cognitive Load Instrument and Initial Validity Evidence

Abstract

PurposeFellows and residents provide inpatient consultations. Though consults vary considerably, measuring the associated cognitive load (CL) is key to guiding faculty on how to optimize learning during consults. However, existing CL instruments, such as the unidimensional Paas scale, cannot separate the 3 components of CL and may miss the nuances of consult CL. Therefore, the authors developed the Consult Cognitive Load (CCL) instrument to measure the 3 CL components during consults. To provide a window into the vital yet underresearched consult learning environment and to improve training and patient care, we developed a multidimensional instrument to measure the mental effort associated with trainees completing inpatient consults.

Using Item‐Response Theory to Improve Interpretation of the Trans Woman Voice Questionnaire

“…Item response thresholds represent levels within items (e.g., never sometimes, often, always), and higher thresholds measure higher levels of the construct. 15,17,23,24 As explained further in Results, these thresholds correspond to the location on the scale where respondents are equally likely to endorse the item at or above the level in question versus cumulative level(s) below. Placing persons and items on the same visual map allows for assessment of not only how well the two align, but also other patterns in responses, such as threshold banding.…”

“…Although lower thresholds will always be below higher thresholds within an item, threshold banding occurs when the same thresholds across items are "banded" into distinct segments, which helps to divide the scale into descriptive regions based on response patterns. 17,23,24 Interval scaled score. To aid score interpretation, a linear transformation (scaled score = 20Álogit + 145) was applied to the logit scale.…”

“…The results of the PCM were used to form an item-person map, also called a Wright Map, which is a visual representation of instrument structure depicting person locations and item thresholds along the construct, in logits. 12,15,17,23,24 Persons higher along the scale possess more of the construct. Item response thresholds represent levels within items (e.g., never sometimes, often, always), and higher thresholds measure higher levels of the construct.…”

“…In this process, the construct to be measured is laid out a priori along a continuum called the construct map, in qualitatively distinct levels. [15][16][17]23,24 Items are then developed to reflect these theoretical levels, and empirical findings through IRT can then be used to understand how well the items fit the construct. Applying IRT in conjunction with a clear construct as a theory for measurement can advance instrument development and measurement for both research and clinical care.…”

Moving From Theory to Practice in Oncology Education When Virtual Is Your Reality

“…Intrinsic load: associated with the task itself Extraneous load: associated with distractions Germane load: left over for learning after intrinsic and extraneous loads are accounted for This framework has been applied in health professions education, 6,7 resulting in tools constructed to measure cognitive load in specific learning settings. [8][9][10] Furthermore, this framework has led to specific recommendations for educators to optimize cognitive load for health professions learners. 11,12 Desirable strategies include (1) optimizing intrinsic load, (2) minimizing extraneous load, and (3) promoting germane load.…”