Temporal pattern of emotions and cognitive load during simulation training and debriefing

Abstract

Background: In the simulated clinical environment, there is a perceived benefit to the emotional activation experienced by learners; however, potential harm of excessive and/or negative emotions has also been hypothesized. An improved understanding of the emotional experiences of learners during each phase of the simulation session will inform instructional design.

Methods: In this observational study, we asked 174 first-year medical students about their emotional state upon arrival to the simulation lab (t1). They were then trained on a standard simulation scenario, after which they rated their emotional state and perceived cognitive load (t2). After debriefing, we then asked them to again rate their emotions and cognitive load (t3).

Results: Students reported that their experience of tranquility (a positive and low-arousal state) dropped from pre-scenario (t1) to post-scenario (t2), and returned to baseline levels after debriefing (t3), from 0.69 (0.87) to 0.14 (0.78) to 0.62 (0.78). Post scenario cognitive load was rated to be moderately high at 6.62 (1.12) and scores increased after debriefing to 6.90 (1.05) d = 0.26, p < 0.001. Cognitive load was associated with the simultaneous measures of emotions at both t2 and t3.

Conclusions: Participant emotions are significantly altered through the experience of medical simulation and emotions are associated with subjective ratings of cognitive load.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Cognitive load theory: Was designed to provide guidelines intended to assist in the presentation of information in a manner that encourages learner activities that optimize intellectual performance. The theory assumes a limited capacity working memory … as well as an effectively unlimited long-term memory, holding schemas that vary in their degree of automation. These structures and functions of human cognitive architecture have been used to design a variety of novel instructional procedures based on the assumption that working memory load should be reduced and schema construction encouraged.

Sweller J, Van Merriënboer J, Paas F. 1998. “Cognitive architecture and instructional design”. Educ Psychol Rev. 10 (3):251–296.

Additional information

Notes on contributors

Kristin Fraser

Kristin Fraser, MD, FRCPC, is a Clinical Professor of Respirology and a Medical Educator at Cumming School of Medicine, University of Calgary, Calgary, Canada.

Kevin McLaughlin

Kevin McLaughlin, MD, FRCPC, PhD, is a Medical Education Researcher at Cumming School of Medicine, University of Calgary and a Nephrologist at Foothills Medical Centre, Calgary, Canada.