Examination of Cognitive Load in Nursing Simulation

Abstract

The pedagogy of cognitive load theory (CLT) was used to examine student learning via simulation. The study’s framework incorporated CLT into simulation design and implementation and presented a pilot measurement tool for cognitive load experienced during simulation. A quasi-experimental quantitative design was used with a convenience sample of senior baccalaureate nursing students who participated in simulation as part of their coursework. The treatment group received a worked out modelling intervention, based in the CLT instructional intervention of the worked out example. The control group received a standard simulation intervention. Each group was given a pre and post simulation knowledge survey related to simulation content and a cognitive load survey post simulation to measure whether the worked out modelling intervention had any effect on cognitive load experienced and knowledge acquired from the simulation experience. Results suggested that students receiving the worked out modeling intervention possessed higher knowledge attainment scores specific to fall management. No significant differences were found in the level of cognitive load experienced between groups; although additional measures identified that the use of a pre simulation activity does increase germane load, which is necessary for schema construction. The findings support continued evaluation of cognitive load and it’s effect in nursing simulation outcomes. Recommendations include integration of CLT concepts into simulation design, use of pre and post knowledge tests to ascertain simulation effectiveness, continued use of a pre simulation assignment to enhance germane load, and the use of worked out modeling in some form prior to simulation with novel content.