Cognitive Load Theory (CLT) builds upon established models of human memory that include the subsystems sensory, working and long-term memory. Working (WM) can only process a limited number information elements at any given time. This constraint creates "bottleneck" for learning. CLT identifies three types cognitive load impact WM: intrinsic (associated with performing essential aspects task), extraneous non-essential task) germane deliberate use strategies facilitate learning). When...

Importance: Single-site studies have described an association between use of selective serotonin reuptake inhibitors (SSRIs) and adverse outcomes surgery.Multicenter including a broad range surgical procedures that explore rare outcomes, such as bleeding mortality, account for indications administration SSRIs are needed.Objective: To determine whether perioperative is associated with surgery in national sample patients.Design: Retrospective study patients 18 years or older who underwent...

Major healthcare reform, including limits on work hours for health professionals and the involvement of multiple individuals, teams settings have made handovers a common frequent aspect patient care. Research has shown that errors commonly occur during handovers, can result in harm.1 ,2 As result, systems, at behest regulatory agencies, must now ensure handover processes are safe reliable. Similarly, medical education programmes credentialing bodies required to monitor clinician competence...

Recent research has explored computational tools to manage workplace stress via personal sensing, a measurement paradigm in which behavioral data streams are collected from technologies including smartphones, wearables, and computers. As these develop, they invite inquiry into how can be appropriately implemented towards improving workers' well-being. In this study, we proposition through formative interviews followed by design provocation centered around measuring burnout U.S. resident...

With the rise of competency-based medical education and workplace-based assessment (WBA) since turn century, much has been written about methods assessment. Direct observation other sources information have become standard in many clinical programs. Entrustable professional activities (EPAs) also a central focus workplace. Paper pencil (one earliest mobile technologies!) to document observations almost obsolete with advent digital technology. Typically, supervisors are asked ratings using...

Cognitive load theory, focusing on limits of the working memory, is relevant to medical education; however, factors associated with cognitive during procedural skills training are not well characterized. The authors sought determine how features learners, patients/tasks, settings, and supervisors were three types among learners performing a specific procedure, colonoscopy, identify implications for teaching.Data collected through an electronically administered survey sent 1,061 U.S....

Few studies have investigated cognitive factors affecting learning of procedural skills in medical education. Cognitive load theory, which focuses on working memory, is highly relevant, but methods for measuring during training are not well understood. Using colonoscopy as an exemplar, we used theory to develop a self-report instrument measure three types (intrinsic, extraneous and germane load) provide evidence validity.We developed the (the Load Inventory Colonoscopy [CLIC]) using...

To develop entrustable professional activities (EPAs) for psychiatry and to demonstrate an innovative, validity-enhancing methodology that may be relevant other specialties.A national task force employed a three-stage process from May 2014 February 2017 EPAs psychiatry. In stage 1, the used iterative consensus-driven construct proposed EPAs. Each included title, full description, competencies. 2, interviewed four nonpsychiatric experts in further revised 3, performed Delphi study of...

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The transfer of a patient from one clinician to another is high-risk event. Errors are common and lead harm. More effective methods for learning how give receive sign-out an important public health priority.Performing handoff complex task. Trainees must simultaneously apply integrate clinical, communication, systems skills into time-limited highly constrained activity. task demands can easily exceed the information-processing capacity trainee, resulting in impaired performance. Appreciating...

The application of cognitive load theory to workplace-based activities such as patient handovers is hindered by the absence a measure different types. This exploratory study tests method for measuring during handovers.The authors developed Cognitive Load Inventory Handoffs (CLI4H) with items intrinsic, extraneous, and germane load. Medical students completed after participating in simulated handover. Exploratory factor correlation analyses were performed collect evidence validity.Results...

Introduction Mobile apps that utilize the framework of entrustable professional activities (EPAs) to capture and deliver feedback are being implemented. If EPA be successfully incorporated into programmatic assessment, a better understanding how they experienced by end-users will necessary. The authors conducted qualitative study using Consolidated Framework for Implementation Research (CFIR) identify enablers barriers engagement with an app.
 Methods Structured interviews faculty...

The COVID-19 pandemic has disrupted many societal institutions, including health care and education. Although the pandemic's impact was initially assumed to be temporary, there is growing conviction that medical education might change more permanently. International Competency-based Medical Education (ICBME) collaborators, scholars devoted improving physician training, deliberated how raises questions about competence. We formulated 12 broad-reaching issues for discussion, grouped into...

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Entrustable professional activities (EPAs) can be used to operationalize competency-based medical education. Mobile apps efficiently capture feedback based on direct observation. To leverage the benefits of both, authors developed an assessment tool that combines EPAs with mobile technology.The designed app collect EPA data observation using human-technology interface guidelines. Data collected in included: name resident, 13 end-of-training for psychiatry, entrustment ratings, and corrective...

Abstract Purpose Medical training institutions worldwide must be prepared to remediate struggling learners, but there is little empirical evidence around learners’ perspectives on remediation efforts. Research shows that emotion has a significant effect learning, it not been well studied in medical education. Given the high stakes of remediation, understanding more about emotional experience could lead improvements programs. This study aimed explore students’ failure and offer opportunities...

Improving patient safety during handovers has become a public health priority.1 Over the past decade, number of best practices have emerged, which, taken together, represent first generation handover interventions. Largely adapted from industries (such as aviation and railroad) in which transition errors high consequences,2 these first-generation aim to reduce information loss distortion via structured communication protocols such face-to-face written sign-out that use mnemonics standardised...

Research has shown that taking 'timeouts' in medical practice improves performance and patient safety. However, the benefits of timeouts, or pausing, are not sufficiently acknowledged workplaces training programmes. To promote this acknowledgement, we suggest a systematic conceptualisation pause, focusing on its importance, processes implementation By employing insights from educational cognitive psychology, first identified pausing as an important skill to interrupt negative momentum...

Problem: Prior studies have reported significant negative attitudes amongst both faculty and residents toward direct observation feedback. Numerous contributing factors been identified, including insufficient time for feedback, poorly understood purpose, inadequate training, disbelief in the formative intent, inauthentic resident-patient clinical interactions, undermining of resident autonomy, lack trust between faculty-resident dyad, low-quality feedback information that lacks credibility....