Thrive or overload? The effect of task complexity on novices’ simulation-based learning

Haji, Faizal; Cheung, Jeffrey J. H.; Woods, Nicole N.; Regehr, Glenn; Ribaupierre, Sandrine de; Dubrowski, Adam

doi:10.1111/medu.13086

Cited by 79 publications

(61 citation statements)

References 71 publications

(172 reference statements)

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“…6 Recent evidence suggests that reduced task complexity in procedural skills training for novice learners is associated with superior task performance and lower cognitive load during the learning phase, but with mixed results on transfer of learning. 11 These results indicate that task complexity, regulated through patient characteristics and environment features, plays an important role in simulation-based learning outcomes. However, these conclusions can hardly be generalised to non-procedural skills training because the process of skill acquisition may differ.…”

mentioning

confidence: 91%

“…The authors also revealed that a lack of prior experience and the need to integrate multiple skills in one scenario contribute to increasing the perception of task complexity . Recent evidence suggests that reduced task complexity in procedural skills training for novice learners is associated with superior task performance and lower cognitive load during the learning phase, but with mixed results on transfer of learning . These results indicate that task complexity, regulated through patient characteristics and environment features, plays an important role in simulation‐based learning outcomes.…”

Section: Introductionmentioning

confidence: 98%

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Simulation‐based education for novices: complex learning tasks promote reflective practice

et al. 2018

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Context Simulated clinical immersion (SCI), in which clinical situations are simulated in a realistic environment, safely and gradually exposes novices to complex problems. Given their limited experience, undergraduate students can potentially be quite overwhelmed by SCI learning tasks, which may result in misleading learning outcomes. Although task complexity should be adapted to the learner's level of expertise, many factors, both intrinsic and extraneous to the learning task, can influence perceived task complexity and its impact on cognitive processes. Objectives The purpose of this mixed‐methods study was to understand the effects of task complexity on undergraduate pharmacy students’ cognitive load, task performance and perception of learning in SCI. Methods A total of 167 second‐year pharmacy students were randomly assigned to undertake one simple and one complex learning task in SCI consecutively. Participants’ cognitive load was measured after each task and debriefing. Task performance and time on task were also assessed. As part of a sequential explanatory design, semi‐structured interviews were conducted with students showing maximal variations in intrinsic cognitive load to elucidate their perceptions of learning when dealing with complexity. Results Although the complex task generated significantly higher cognitive load and time on task than the simple task, performance was high for both tasks. Qualitative results revealed that a lack of clinical experience, an unfamiliar resource in the environment and the constraints inherent to SCI, such as time limitations, hindered the clinical reasoning process and led to poorer self‐evaluation of performance. Simple tasks helped students gain more self‐confidence, whereas complex tasks further encouraged reflective practice during debriefings. Conclusions Although complex tasks in SCI were more cognitively demanding and took longer to execute, students indicated that they learned more from them than they did from simple tasks. Complex tasks constitute an additional challenge in terms of clinical reasoning and thus provide a more valuable learning experience from the student's perspective.

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confidence: 91%

Section: Introductionmentioning

confidence: 98%

Simulation‐based education for novices: complex learning tasks promote reflective practice

et al. 2018

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“…It has been utilised to generate instructional principles for designing anatomical multimedia and generalisable design guidelines for medical education . Further, CLT has served as a useful lens when analysing medical training methods …”

Section: Introductionmentioning

confidence: 99%

The effect of autostereoscopic holograms on anatomical knowledge: a randomised trial

Hackett

Proctor

2018

Medical Education

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Context Three‐dimensional (3‐D) visualisation in anatomical education has been shown to be broadly beneficial for students. However, there is limited research on the relative efficacy of 3‐D modalities. This study compares knowledge performance, mental effort and instructional efficiency between autostereoscopic 3‐D visualisation (holograms), monoscopic 3‐D visualisation (3‐DPDFs) and a control (2‐D printed images). Methods A cardiac anatomy model was used to generate holograms, 3‐DPDFs and 2‐D printed images. Nursing student participants (n = 179) were randomised into three groups: holograms (n = 60), 3‐DPDFs (n = 60) and printed images (n = 59). Participants completed a pre‐test followed by a self‐study period using the anatomical visualisation. Afterwards, participants completed the NASA‐Task Load Index (NASA‐TLX) cognitive load instrument and a knowledge post‐test. Results Post‐test results showed participants studying with holograms (median = 80.0, interquartile range [IQR] = 66.7–86.7) performed significantly better regarding cardiac anatomy knowledge than participants using 3‐DPDF (median = 66.7, IQR = 53.3–80.0, p = 0.008) or printed images (median = 66.7, IQR = 53.3–80.0, p = 0.007). Mental effort scores, on a scale from 1 to 20, showed hologram (mean = 4.9, standard deviation [SD] = 3.56) and 3‐DPDF participants (mean = 4.9, SD = 3.79) reported significantly lower cognitive load than printed images (mean = 7.5, SD = 4.9, p < 0.005). Instructional efficiency (E) of holograms (E = 0.35) was significantly higher than printed images (E = −0.36, p < 0.001), although not significantly higher than 3‐DPDF (E = 0.03, p = 0.097). Conclusions Participants using holograms demonstrated significant knowledge improvement over printed images and monoscopic 3‐DPDF models, suggesting additional depth cues from holographic visualisation provide benefit in understanding spatial anatomy. Mental effort scores and instructional efficiency of holograms indicate holograms are a cognitively efficient instructional medium. These findings highlight the need for further study of novel 3‐D technologies and learning performance.

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“…In other words, if it looks like the ‘real thing’, it should transfer to the clinical setting. Recently, there has been discussion among simulation experts and educators about whether greater physical fidelity really is important for psychomotor development and skill attainment 4. Researchers found higher task complexity may increase cognitive load and worsen performance among novices and early learners.…”

Section: Introductionmentioning

confidence: 99%

“…Researchers found higher task complexity may increase cognitive load and worsen performance among novices and early learners. Reduced task complexity was associated with superior performance 4. This raises the question of how does physical fidelity impact cognitive skill development?…”

Section: Introductionmentioning

confidence: 99%

Varying levels of fidelity on psychomotor skill attainment: a CORTRAK product assessment

2018

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BackgroundA task trainer is defined as a model that represents a part or region of the human body such as an arm and an abdomen… generally used to support procedural skills training. Concepts for consideration when selecting a task trainer include fidelity and cognitive load. Insertion of small - bore FTs in acutely ill patients continues to be a high - risk skill. The most frequent complication is insertion of the F T into the pulmonary system, which can lead to pneumothorax, pneumonitis and death. Training consists of placing the FT under electromagnetic visual assistance in a task trainer.ObjectiveThis study describes assessment of two task trainers that are used to simulate assisted feeding tube (FT) insertion. Simulation is an excellent approach to close the learning gap and ensure competency. Study selection: This study used a prospective observational design. Participants (n=20) were registered nurses considered to be superusers. They were randomly assigned to order of the task trainer.Findings and conclusionsThe findings suggest the learners preferred the low-fidelity task trainer. The clear Anatomical Box scored higher overall (18.35/21) when compared with the human-like task trainer (16.5/21). A higher fidelity task trainer may seem attractive; however, with a lens to cognitive load theory, it may hinder the early learning process. Fidelity requirements vary depending on the training task. Recommendations from this study include: initial instruction should focus on the psychomotor steps for the FT insertion process. The high-fidelity human torso is recommended for performance, final competency and ongoing competency maintenance.

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Thrive or overload? The effect of task complexity on novices’ simulation-based learning

Cited by 79 publications

References 71 publications

Simulation‐based education for novices: complex learning tasks promote reflective practice

Simulation‐based education for novices: complex learning tasks promote reflective practice

The effect of autostereoscopic holograms on anatomical knowledge: a randomised trial

Varying levels of fidelity on psychomotor skill attainment: a CORTRAK product assessment

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