Cognitive load theory for training health professionals in the workplace: A BEME review of studies among diverse professions: BEME Guide No. 53

<b>Aim:</b> Cognitive load theory (CLT) is of increasing interest to health professions education researchers. CLT has intuitive applicability to workplace settings, yet how CLT should inform teaching, learning, and research in health professions workplaces is unclear. <b>Method:</b> To map the existing literature, we performed a scoping review of studies involving cognitive load, mental effort and/or mental workload in professional workplace settings within and outside of the health professions. We included actual and simulated workplaces and workplace tasks. <b>Result:</b> Searching eight databases, we identified 4571 citations, of which 116 met inclusion criteria. Studies were most often quantitative. Methods to measure cognitive load included psychometric, physiologic, and secondary task approaches. Few covariates of cognitive load or performance were studied. Overall cognitive load and intrinsic load were consistently negatively associated with the level of experience and performance. Studies consistently found distractions and other aspects of workplace environments as contributing to extraneous load. Studies outside the health professions documented similar findings to those within the health professions, supporting relevance of CLT to workplace learning. <b>Conclusion:</b> The authors discuss implications for workplace teaching, curricular design, learning environment, and metacognition. To advance workplace learning, the authors suggest future CLT research should address higher-level questions and integrate other learning frameworks.

研究目的：认知负荷理论（Cognitive Load Theory, CLT）日益受到卫生职业教育研究者的关注。尽管CLT在工作场景中具备直观的应用潜力，但目前尚未明确应如何将其应用于卫生职业工作场所的教学、学习与研究活动。研究方法：为系统梳理现有相关文献，我们开展了一项范围综述，纳入涉及卫生职业及非卫生职业专业工作场景中的认知负荷、心理努力及/或心理工作负荷的相关研究，研究对象涵盖实际工作场景与模拟工作场景及其对应的工作任务。研究结果：通过检索8个数据库，我们共获取4571篇引文，其中116篇符合纳入标准。绝大多数研究采用定量研究设计。认知负荷的测量方法包括心理测量法、生理学测量法以及次级任务法。针对认知负荷或绩效的协变量研究较为匮乏。总体认知负荷与内在负荷均与个体经验水平及绩效水平呈显著负相关。研究一致表明，分心因素及工作场所环境的其他方面会增加额外认知负荷。非卫生职业领域的研究得出了与卫生职业领域相似的结论，证实了CLT对工作场所学习的应用价值。研究结论：作者探讨了CLT在工作场所教学、课程设计、学习环境构建以及元认知培养等方面的应用启示。为推动工作场所学习的发展，作者建议未来的CLT研究应聚焦更高层次的科学问题，并整合其他学习理论框架。