Collaborative use of virtual patients after a lecture enhances learning with minimal investment of cognitive load

Abstract

Background: The use of virtual patients (VPs), due to their high complexity and/or inappropriate sequencing with other instructional methods, might cause a high cognitive load, which hampers learning.

Aim: To investigate the efficiency of instructional methods that involved three different applications of VPs combined with lectures.

Method: From two consecutive batches, 171 out of 183 students have participated in lecture and VPs sessions. One group received a lecture session followed by a collaborative VPs learning activity (collaborative deductive). The other two groups received a lecture session and an independent VP learning activity, which either followed the lecture session (independent deductive) or preceded it (independent inductive). All groups were administrated written knowledge acquisition and retention tests as well as transfer tests using two new VPs. All participants completed a cognitive load questionnaire, which measured intrinsic, extraneous and germane load. Mixed effect analysis of cognitive load and efficiency using the R statistical program was performed.

Results: The highest intrinsic and extraneous load was found in the independent inductive group, while the lowest intrinsic and extraneous load was seen in the collaborative deductive group. Furthermore, comparisons showed a significantly higher efficiency, that is, higher performance in combination with lower cognitive load, for the collaborative deductive group than for the other two groups.

Conclusion: Collaborative use of VPs after a lecture is the most efficient instructional method, of those tested, as it leads to better learning and transfer combined with lower cognitive load, when compared with independent use of VPs, either before or after the lecture.

Acknowledgements

Authors would like to thank all the members of Oral and Maxillofacial Surgery Division who revised the lectures content and established the content validity of the different tests.

Disclosure statement

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

Additional information

Notes on contributors

Hesham F. Marei

Hesham F. Marei, MSc, FDSRCS (Eng.), PhD (OMFS), MHPE, is an Associate Professor and Consultant of Oral and Maxillofacial Surgery, at College of Dentistry, Imam Abdulrahman Bin Faisal University, Saudi Arabia. Dr. Marei is currently a PhD fellow at School of Health Professions Education, Maastricht University, the Netherlands.

Jeroen Donkers

Jeroen Donkers, PhD, is an Assistant Professor, at the Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, Maastricht University, the Netherlands.

Mohamed M. Al-Eraky

Mohamed M. Al-Eraky, MBBCh, MSc, MMEd, PhD, is an Assistant Professor of Medical Education. He is currently appointed as Director of Development & Academic Initiatives at the Vice-President Office for Academic Affairs at Imam Abdulrahman Bin Faisal University, Saudi Arabia.

Jeroen J. G. Van Merrienboer

Jeroen J. G. Van Merrienboer, PhD, is a Professor of Learning and Instruction, at the Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands. He is Research Director of the School of Health Professions Education.