Learning Echocardiography in the Workplace

A Cognitive Load Perspective

Bibliographic Data

ID21612357
AuthorsSarah Blissett (0000-0002-2465-1487, S. Blissettwas an adult congenital heart disease fellow, Department of Medicine, University of California, San Francisco, San Francisco, California, at the time of this study. The author is now assistant professor, Department of Medicine, Division of Cardiology, and a researcher at the Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada., corresponding author), Sebastián Rodríguez (0000-0002-7063-0177, University of California System), Atif Qasim (University of California System), Patricia O’sullivan (0000-0002-8706-4095, University of California System)
Year2021
Volume96
Issue3
Pages441-448
Publication date2021-03-01
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000003789
PMID33031115
OpenAlexW3091910042
LanguageEN
Citations received4
References cited25

PURPOSE: Although workplace learning environments provide authentic tasks to promote learning, elements of clinical settings may distract trainees and impede learning. The characteristics of workplace learning environments that require optimization are ill-defined. Applying principles of cognitive load theory (CLT) to optimize learning environments by managing intrinsic load (complexity of the task matched to learner knowledge and skill), minimizing extraneous load (any aspect that is not part of task completion), and increasing germane load (processing for storage in long-term memory) could be advantageous. The authors explored trainee perceptions of characteristics that helped or impaired learning from a cognitive load perspective. Echocardiography interpretation was used as a model. METHOD: The authors conducted semistructured interviews between December 2018 and March 2019 with a purposeful sample of 10 cardiology trainees at the University of California, San Francisco, School of Medicine until thematic sufficiency was achieved. Participants represented a range of training levels (3 fourth-year trainees, 2 fifth-year trainees, 3 sixth-year trainees, and 2 advanced echocardiography fellows) and career aspirations (4 desired careers in imaging). Two independent coders analyzed interview transcripts using template analysis. Codes were mapped to CLT subcomponents. RESULTS: Trainees selected their own echocardiograms to interpret; if trainees' skill levels and the complexity of the selected echocardiograms were mismatched, excess intrinsic load could result. Needing to look up information essential for task completion, interruptions, reporting software, and time pressures were characteristics that contributed to extraneous load. Characteristics that related to increasing germane load included the shared physical space (facilitating reading echocardiograms with attendings and just-in-time guidance from near peers) and the availability of final reports to obtain feedback independent of teachers. CONCLUSIONS: As interpreted from a cognitive load perspective, findings highlight characteristics of workplace learning environments that could be optimized to improve learning. The findings have direct application to redesigning these learning environments

Cognition · Cognitive Load · Cognitive psychology · Medical education · Perception · Qualitative research · Thematic analysis · Computer Science · Learning Styles and Cognitive Differences · Medicine · Psychology · Radiology practices and education · Visual and Cognitive Learning Processes · Artificial Intelligence

Tools

Open DOI