A Cognitive Load Theory Perspective of the Undergraduate Anesthesia Curricula in South Africa.

Journal

Anesthesia and analgesia

ISSN: 1526-7598

Titre abrégé: Anesth Analg

Pays: United States

ID NLM: 1310650

Informations de publication

Date de publication:
24 Jul 2024

Historique:

medline: 26 7 2024

pubmed: 26 7 2024

entrez: 24 7 2024

Statut: aheadofprint

Résumé

Safe anesthesia is indispensable to achieve global safe surgery and equitable health care access. The disease burden and lack of specialists in South Africa (SA) require junior, nonspecialist doctors to be fit-for-purpose from day 1 when they provide anesthetic services in peripheral hospitals with limited supervision. Graduating students report low self-perceived preparedness for administering anesthesia, but it is not known how their curricular experiences influence their learning. Cognitive load theory defines intrinsic, extraneous, and germane cognitive loads (subtypes). Intrinsic load relates to learning tasks, extraneous load to distractions, and germane load to students' learning processes. This study used a cognitive load theory lens to explore SA students' experiences of their undergraduate anesthesia training. In a constructivist cross-sectional descriptive study, we explored the qualitative factors that influenced students' curricular experience of undergraduate anesthesia training in SA. Two investigators analyzed the data independently in an initial coding round. An emerging theme of lack of time to achieve the expected outcomes, prompted the use of cognitive load theory as a conceptual framework for further analysis by the 3 authors. The subsequent analysis informed the development and refinement of a final cognitive load theory framework for anesthesia training, the COLOAD (COgnitive LOad in Anesthesia eDucation) framework. Data were collected between November 2017 and February 2019. The 1336 respondents (79% participation) reported a variety of determinants of learning pertaining to all 3 cognitive load subtypes. Participants were novices in an inherently complex environment and experienced a high cognitive load during anesthesia training. The number-, complexity-, and interactivity of tasks influenced intrinsic load, while extraneous load was affected by ineffective instructional methods, external- and internal distractors. Program design, metacognition, and learner motivation impacted germane load. Cognitive load theory provided a useful theoretical basis for understanding students' curricular experiences. The COLOAD framework suggests a microlevel interrelatedness of the constituting elements of the 3 cognitive load subtypes. This has implications for curriculum design, pedagogy, and student support. Learning outcomes development and curriculum mapping are important to ensure a lean curriculum, but measures to enhance germane cognitive load might be equally important to achieve competence. Attention to the hidden curriculum and active promotion of reflective practice might reduce cognitive load in complex learning environments such as anesthesia training.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

In a constructivist cross-sectional descriptive study, we explored the qualitative factors that influenced students' curricular experience of undergraduate anesthesia training in SA. Two investigators analyzed the data independently in an initial coding round. An emerging theme of lack of time to achieve the expected outcomes, prompted the use of cognitive load theory as a conceptual framework for further analysis by the 3 authors. The subsequent analysis informed the development and refinement of a final cognitive load theory framework for anesthesia training, the COLOAD (COgnitive LOad in Anesthesia eDucation) framework.

RESULTS RESULTS

Data were collected between November 2017 and February 2019. The 1336 respondents (79% participation) reported a variety of determinants of learning pertaining to all 3 cognitive load subtypes. Participants were novices in an inherently complex environment and experienced a high cognitive load during anesthesia training. The number-, complexity-, and interactivity of tasks influenced intrinsic load, while extraneous load was affected by ineffective instructional methods, external- and internal distractors. Program design, metacognition, and learner motivation impacted germane load.

CONCLUSIONS CONCLUSIONS

Cognitive load theory provided a useful theoretical basis for understanding students' curricular experiences. The COLOAD framework suggests a microlevel interrelatedness of the constituting elements of the 3 cognitive load subtypes. This has implications for curriculum design, pedagogy, and student support. Learning outcomes development and curriculum mapping are important to ensure a lean curriculum, but measures to enhance germane cognitive load might be equally important to achieve competence. Attention to the hidden curriculum and active promotion of reflective practice might reduce cognitive load in complex learning environments such as anesthesia training.

Identifiants

DOI: 10.1213/ANE.0000000000007033 PMID: 39046910

pubmed: 39046910

doi: 10.1213/ANE.0000000000007033

pii: 00000539-990000000-00875

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : South African Society of Anaesthesiologists

ID : N/A

Informations de copyright

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest.

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