Effects of the Physical Environment on Cognitive Load and Learning: Towards a New Model of Cognitive Load

The Application of Cognitive Load Theory to the Design of Health and Behavior Change Programs: Principles and Recommendations

Health and behavior change programs play a crucial role in improving health behaviors at individual and family levels. However, these programs face challenges with engagement and retention and typically show modest efficacy. Cognitive load theory is an established and highly used educational theory that proposes individuals have a finite capacity to process new information ("working memory"). Learning, engagement, and performance are negatively impacted when working memory is exceeded. Cognitive load theory is grounded in an understanding of human cognition and conceptualizes different types of cognitive loads imposed on individuals by a learning experience. Cognitive load theory aims to guide the design of learning experiences, considering how the human mind works, leading to more meaningful and effective learning. Cognitive load theory is increasingly applied to domains outside the classroom, such as designing patient and clinical education. Applying cognitive load theory to the design of health programs, their materials, and interfaces can provide insights. By considering the cognitive demands placed on individuals when interacting with health programs, design can be optimized to reduce cognitive load and better facilitate learning and behavior adoption. This may enhance engagement, retention, and effectiveness of programs. Cognitive load theory may be particularly valuable for individuals with diminished working memory due to high levels of mental load and stress. Design principles are presented to consolidate knowledge from cognitive load theory and existing approaches to guide researchers, policymakers, and health programmers. Further research and interdisciplinary collaboration are needed to realize the potential of cognitive load theory in health.

The combined impacts of indoor temperature and total volatile organic compounds on cognitive performance of university students: A controlled exposure study

Volatile Organic Compound (VOC) emissions from building materials increase at high indoor temperatures, especially in newly built and refurbished buildings. With climate change driving indoor overheating, future students may face elevated indoor temperature and Total Volatile Organic Compounds (TVOC) levels simultaneously. This study investigated the combined impacts of temperature and VOCs on human cognitive performance. Seventy-one university students participated in an experiment conducted in a controlled climate chamber using a single-blind, 2 × 2 within-between participant design. The study employed two temperature levels (23 °C vs. 28 °C, within participants) and two TVOC concentrations (100 μg/m3 vs. 1000 μg/m3, between participants). Cognitive performance was assessed by a computer-based test battery. Participants' perceptions of thermal sensation, air quality and physical symptoms were collected via a paper-based questionnaire. Results indicate that temperature significantly impacts task accuracy, while TVOC levels do not. There was no clear evidence that either temperature or TVOC levels affected reaction speed. There was no interaction effect between temperature and TVOC level. Within-group tests showed a significant accuracy impact in six of ten tasks at 28 °C under 1000 μg/m3 TVOC, with an average task error increase of 5.2 %. Higher temperatures led to worse perceived air quality. During exposure, symptoms such as eye irritation and fatigue developed. These findings suggest that indoor overheating affects cognitive function and overall well-being. Future standards for VOCs may need to be adjusted based on temperature. It is important to propose a lower limit for TVOC at higher temperatures, as this is crucial for managing both overheating and TVOC levels during the summer.

Incorporating Patient and Family Perspectives into ICU Environmental Design: A Systematic Review and Narrative Synthesis of Existing Literature

OBJECTIVE

This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.

BACKGROUND

Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery. While architects historically dominated design decisions, there's no recognition of the necessity to integrate patient and family perspectives. However, such efforts remain rare despite professional guidelines advocating for multi-professional team involvement.

METHODS

This review summarises the published literature on built ICUs that have incorporated patient and family input into the design process. It evaluates methodologies used and measures patient-centric outcomes to identify successful examples and areas for improvement in future initiatives.

RESULTS

The limited published literature identifies only three projects successfully integrating patient and family input into ICU design. Additionally, one project was identified in a search of the gray literature. However, these projects often lack rigorous evaluation of patient-centric outcomes, with initiatives involving patients and families remaining uncommon. The review underscores the need for more comprehensive evaluation and greater emphasis on patient and family involvement in ICU design.

CONCLUSION

This review emphasizes the significance of integrating patient perspectives into ICU design to enhance outcomes and improve experiences. While progress has been made in recognizing their importance, more efforts are needed to prioritize patient and family involvement for creating conducive environments for healing and recovery.

Environmental Features of in Situ and Laboratory Simulations and Their Potential Impact on the Development of Teamwork Skills for Novice Trauma Professionals

BACKGROUND

The effect of environmental fidelity on the development of teamwork skills in health care simulations is unclear. This preliminary descriptive study explored how in situ and laboratory environments impact the development of teamwork skills among novice trauma professionals.

METHOD

Four teams of six novice trauma professionals participated in two in situ or two laboratory simulations. Environmental features such as noise, interruptions, and the presence of nonparticipating individuals were assessed. Teamwork skills were evaluated from video recordings with the Team Emergency Assessment Measure (TEAM).

RESULTS

In situ simulations involved higher levels of noise, more interruptions, and the presence of nonparticipating individuals compared with laboratory simulations. Teamwork skills in the in situ setting were rated as poor, with no improvement between simulations. In contrast, in the laboratory setting, teamwork skills were rated as good, with a 10-point improvement.

CONCLUSION

Preliminary results suggest that the in situ environment may hinder the development of teamwork skills. Further research with larger samples is needed to explore these effects and guide educators in choosing optimal training environments for novice trauma health care professionals. [J Contin Educ Nurs. 2025;56(1):34-40.].

Brain and Subjective Responses to Indoor Environments Related to Concentration and Creativity

Electroencephalograms (EEGs) can be used to study the influence of environmental elements on human emotions, cognition, and behavior. EEGs can reveal unconscious responses and fill in the gaps left by subjective responses provided in survey questionnaires or interviews. EEG research on the impact of classroom design elements on concentration and creativity is scarce; the design elements studied have not been diverse enough. In addition, no researchers have examined the brain and subjective responses to multiple indoor environmental elements regarding concentration and creativity. Thus, the purpose of this study was to explore how the human brain responds to different indoor environmental elements as shown by objective EEG signals related to concentration and creativity, and their similarities and differences to subjective self-reported responses. The experimental stimuli included 16 images combining four indoor environmental elements-classroom space shape, furniture arrangement, ceiling height, and color-along with images of white walls, a full-window wall with a view of nature, and a windowless scenario, totaling 19 images. The brainwaves of 20 people collected from eight channels were analyzed to determine the concentration index (CI) for concentration and relative theta (RT) for creativity. As a subjective response, participants were asked to choose the stimuli in which they felt they could best concentrate and be most creative in a self-report format. The results showed the following tendencies: (a) More brainwaves in the parietal and occipital lobes than in the prefrontal or frontal lobes; (b) a higher CI with rectilinear shapes, traditional frontal furniture arrangements, and red walls; (c) a higher RT with curvilinear shapes, collaborative furniture arrangements, white walls, and a full view of nature; and (d) participants selected white walls and a front-facing furniture layout as supportive of concentration and a full view of nature, curvilinear shape, and collaborative furniture layout for creative thinking. The results showed that similarities in brain and subjective responses were related to furniture layout and shape, whereas differences existed in color. This study contributes to the understanding of the characteristics of indoor environments that appear to enhance the manifestation of concentration and creativity.

Leveraging digital skills to reduce cognitive strain: Implications for academic self-efficacy in medical education

BACKGROUND

Digital literacy influences academic behaviors, especially in medical education, where students encounter considerable academic challenges. However, the effects of this phenomenon on academic self-efficacy and cognitive load remain inadequately understood.

OBJECTIVES

This research explores the relationships between digital literacy and academic self-efficacy, emphasizing the mediating role of cognitive load and its various dimensions among medical students in Islamabad, Pakistan.

METHODS

A descriptive cross-sectional survey was conducted from seven medical colleges in Islamabad, Pakistan, from October to December 2023. The research employed meticulously validated measurement tools encompassing a digital literacy scale, academic self-efficacy scale, and cognitive load scale and collected data on 633 medical students. Descriptive statistics and inferential testing (mediation analysis) were performed to investigate the direct and indirect relationships of the study variables.

RESULTS

The empirical results revealed that digital literacy significantly enhances academic self-efficacy both directly and indirectly. First, the total cognitive load score showed partial mediation (β = 0.165, p < 0.001). Then, individual subscale analysis revealed that intrinsic cognitive load (β = 0.147, p < 0.001) and extraneous cognitive load (β = 0.144, p < 0.001) were significant mediators. However, the mediation effect through self-perceived learning (β = 0.105, p = 0.361) was not supported, suggesting variability in how students perceive their learning gains or other influencing factors influencing this relationship, which warrants further investigation.

CONCLUSION

The research finding underscores the crucial integration of digital literacy instruction into medical curriculums to bolster students' academic self-efficacy by adeptly managing cognitive load. While digital literacy notably reduces intrinsic and extraneous cognitive loads, its impact on perceived learning appears context-dependent and requires further exploration. Additional studies are needed to understand these relationships across educational settings and identify other potential influencing factors.

Room corners and how they influence the memory of visual information arranged on walls

In formal and informal learning settings corresponding information units are often arranged in the space around the viewer. For example, teachers pin task relevant information on classroom walls, or museum curators arrange exhibits in museum halls. Often learners and visitors are expected to see meaningful relationships between these information units. Theoretically, Gestalt Psychology has been examining the effects of connecting and separating elements in visual information displays, leading to the question of whether these findings also hold in three-dimensional environments. Does the mostly rectangular form of our rooms also either highlight or downplay relations between information dispersed across a room? Three experiments using virtual rooms showed that the matching pairs of pictures were memorized better if both pictures were arranged on the same wall instead of across two adjacent walls: that is, the presence of a room corner between matching pairs decreased memory (Experiments 1-3). Additionally, the findings showed that the participants' orientation of their central field of view during learning influenced the effect of corners on memory. When initially looking around in rooms, participants most often oriented the center of their field of view toward the middle of a wall (Experiments 1 and 2); however, if they were restricted to orienting their field of view toward corners, the corner effect on memory vanished (Experiment 3). These findings suggest that room characteristics influence the exploratory behavior of viewers, thereby also affecting their memories of the presented information.

Investigating Whether the Mass of a Tool Replica Influences Virtual Training Learning Outcomes

Virtual Reality (VR) has emerged as a promising solution to address the pressing concern of transferring know-how in the manufacturing industry. Making an immersive training experience often involves designing an instrumented replica of a tool whose use is to be learned through virtual training. The process of making a replica can alter its mass, making it different from that of the original tool. As far as we know, the influence of this difference on learning outcomes has never been evaluated. To investigate this subject, an immersive training experience was designed with pre and post-training phases under real conditions, dedicated to learning the use of a rotary tool. 80 participants took part in this study, split into three groups: a control group performing the virtual training using a replica with the same mass as the original tool ($\mathrm{m}=100\%$), a second group that used a replica with a lighter mass than the original tool ($\mathrm{m}= 50\%$) and a third group using a replica heavier than the original tool ($\mathrm{m}=150\%$). Despite variations in the mass of the replica used for training, this study revealed that the learning outcomes remained comparable across all groups, while also demonstrating significant enhancements in certain performance measures, including task completion time. Overall, these findings provide useful insights regarding the design of tool replicas for immersive training.

Neurodiversity and cognitive load in online learning: A focus group study

It is widely accepted that cognitive load plays a crucial role in online learning. However, despite neurodevelopmental conditions being the largest category of qualifying disabilities in education, and the rise of online learning, there is little understanding of the factors impacting cognitive load in online learning for neurodivergent students and how these factors differ from those affecting neurotypical students. This study used qualitative comparison groups with neurotypical and neurodivergent students to examine their experiences of cognitive load in online learning. A sample of 26 university students (14 neurotypical and 12 neurodivergent) participated in focus group discussions. While neurodivergent students reported many similar experiences of cognitive load in online learning compared to their neurotypical peers-such as confusion in navigating the content and technical issues-some difficulties were more present for neurodivergent students-such as transcripts including mistakes and inaccessible content presentation-creating additional barriers in effectively engaging with the educational content. The results suggest that neurotypical and neurodivergent students experience similar challenges, albeit to differing degrees of intensity, and that more research is needed to explore the relationship between neurodiversity and cognitive load in online learning.

Reasoning More Efficiently with Primary Knowledge Despite Extraneous Cognitive Load

Geary's evolutionary approach in educational psychology differentiates between primary (low cognitive costs and motivational advantage) and secondary knowledge (high cognitive costs and no motivational benefit). Although these features have been well demonstrated in previous work, the underlying mechanisms remain unclear. To investigate it, in a reasoning task, the present study varies (i) the content of the problems (primary knowledge vs. secondary; e.g., food vs. grammar rules), (ii) the intrinsic cognitive load (conflict or non-conflict syllogism, the former requiring more cognitive resources to be properly processed than the latter) and (iii) the extraneous cognitive load (via a Dot Memory Task with three modalities: low, medium and high cognitive load). Analyses assessed the influence of these variables on performance, problem solving speed and perceived cognitive load. Results confirmed the positive impact of primary knowledge on efficiency, particularly when intrinsic cognitive load was high. Surprisingly, the extraneous cognitive load did not influence the performance in secondary knowledge content but that in primary knowledge content: the higher the additional load was, the better the performance was, only for primary knowledge and especially for syllogisms with high intrinsic load. Findings support evolutionary theory as secondary knowledge would overload cognitive resources, preventing participants from allocating sufficient resources to solve problems. Primary knowledge would allow participants to process the additional load and to increase their performance despite this. This study also raises the hypothesis that a minimum cognitive load is necessary for participants to be invested in the task.

Effects of Exercise Habits and Gender on Sports e-Learning Behavior: Evidence from an Eye-Tracking Study

Background/Objective

In the post-epidemic era, an increasing number of individuals were accustomed to learning sports and physical activity knowledge online for fitness and health demands. However, most previous studies have examined the influence of e-learning materials and resources on learners and have neglected intrinsic factors such as experience and physiological characteristics. Therefore, we conducted a study to investigate the effect of exercise habits and gender on sports e-learning behavior via eye-tracking technology.

Methods

We recruited a sample of 60 undergraduate students (mean age = 19.6) from a university in Nanjing, China. They were randomly assigned into 4 groups based on 2 genders × 2 exercise habits. Their gaze behavior was collected by an eye-tracking device during the experiment. The cognitive Load Test and Learning Effect Test were conducted at the end of the individual experiment.

Results

(1) Compared to the non-exercise habit group, the exercise habit group had a higher fixation count (P<0.05), a shorter average fixation duration (P<0.05), a smaller average pupil diameter (P<0.05), and a lower subjective cognitive load (P<0.05) and better learning outcome (P<0.05). (2) Male participants showed a greater tendency to process information from the video area of interest (AOIs), and had lower subjective cognitive load (P < 0.05) and better learning outcomes (P < 0.05). (3) There was no interaction effect between exercise habits and gender for any of the indicators (P > 0.05).

Conclusion

Our results indicate that exercise habits effectively enhance sports e-learning outcomes and reduce cognitive load. The exercise habits group showed significant improvements in fixation counts, average fixation duration, and average pupil diameter. Furthermore, male subjects exhibited superior learning outcomes, experienced lower cognitive load, and demonstrated greater attentiveness to dynamic visual information. These conclusions are expected to improve sports e-learning success and address educational inequality.

Gamified versus non-gamified online educational modules for teaching clinical laboratory medicine to first-year medical students at a large allopathic medical school in the United States

BACKGROUND

Medical educators seek innovative ways to engage learners efficiently and effectively. Gamification has been explored as one way to accomplish this feat; however, questions remain about which contexts gamification would be most useful. Time constraints and student interest present major barriers for teaching laboratory medicine to students. This study aims to compare two versions of an interactive online module, one gamified and one not, for teaching laboratory medicine concepts to pre-clinical medical students.

METHODS

First-year medical students reviewed either a gamified or non-gamified version of an interactive online module in preparation for an in-person flipped classroom session on Laboratory Medicine. Learning theory guided the design of the modules and both contained identical content, objectives, and structure. The "gamified" module included the additional elements of personalization, progress meters, points, badges, and story/role play. After reviewing the module, students completed an anonymous knowledge check and optional survey.

RESULTS

One hundred seventy-one students completed the post module knowledge check as assigned (82 gamified, 89 non-gamified). Knowledge check scores were higher for the students who reviewed the gamified module (p < 0.02), corresponding to an effect size of 0.4 for the gamified module. Eighty-one students completed optional post-module surveys (46 gamified, 35 non-gamified). Instructional efficiency was calculated using task difficulty questions and knowledge check scores, and the resulting instructional efficiency was higher for the gamified module. There was no significant difference in the student-reported time required to complete the modules. Additionally, both versions of the module were well received and led to positive ratings related to motivation and confidence. Finally, examination of open-ended survey results suggested that the addition of game elements added value to the gamified module and enhanced engagement and enjoyment.

CONCLUSIONS

In this setting, the addition of gamification to an interactive online module enhanced learning outcome, instructional efficiency, student engagement and enjoyment. These results should inspire further exploration of gamification for teaching Laboratory Medicine concepts to pre-clinical medical students.

Collaboration Scripts or Checklists to Engage Novice Observers in Immersive Simulation?

INTRODUCTION

In simulation, students often observe their peers perform a task. It is still unclear how different types of instructional guidance can turn the observational phase into an active learning experience for novices. This mixed-method study aims to understand similarities and differences between use of collaboration scripts and checklists by observers in terms of cognitive load and perception of learning.

METHODS

Second-year pharmacy students ( N = 162) were randomly assigned to 1 of 4 conditions when observing a simulation: collaboration scripts (heuristic to analyze in dyads while observing), checklists, both, or no guidance. We measured observers' intrinsic and extraneous cognitive load and self-perceived learning and conducted focus group interviews.

RESULTS

Intrinsic cognitive load was significantly lower for checklists (M = 3.6/10) than for scripts (M = 4.7/10) or scripts and checklists combined (M = 4.7/10). Extraneous cognitive load was significantly lower for checklists (M = 1.5/10) than for scripts combined with checklists (M = 2.6/10) or no guidance (M = 1.8/10). There was no statistical difference between conditions for self-perceived learning. Coding of focus group interviews revealed 6 themes on observers' perception of learning under different conditions of instructional guidance. Students explained that collaboration scripts felt more complex, whereas checklists were perceived as a simple fact-checking exercise. Observing the simulation, regardless of guidance, was a meaningful learning experience.

CONCLUSIONS

With or without guidance, observers are actively engaged with the simulation, but their effort differed depending on instructions. When choosing between checklists or collaboration scripts, educators should be guided by the type of simulation task.

Creating the ICU of the future: patient-centred design to optimise recovery

BACKGROUND

Intensive Care survival continues to improve, and the number of ICU services is increasing globally. However, there is a growing awareness of the detrimental impact of the ICU environment on patients, families, and staff. Excessive noise and suboptimal lighting especially have been shown to adversely impact physical and mental recovery during and after an ICU admission. Current ICU designs have not kept up with advances in medical technology and models of care, and there is no current 'gold-standard' ICU design. Improvements in ICU designs are needed to optimise care delivery and patient outcomes.

METHODS

This manuscript describes a mixed-methods, multi-staged participatory design project aimed at redesigning and implementing two innovative ICU bedspaces. Guided by the action effect method and the consolidated framework for implementation research, the manuscript describes the processes taken to ensure the patient-centred problems were properly understood, the steps taken to develop and integrate solutions to identified problems, and the process of implementation planning and rebuilding in a live ICU.

RESULTS

Two innovative ICU bedspaces were rebuilt and implemented. They feature solutions to address all identified problems, including noise reduction, optimisation of lighting, access to nature via digital solutions, and patient connectivity and engagement, with solutions developed from various specialty fields, including IT improvements, technological innovations, and design and architectural solutions. Early evaluation demonstrates an improved lighting and acoustic environment.

CONCLUSIONS

Optimising the ICU bedspace environment and improving the lighting and acoustic environment is possible. The impact on patient outcomes needs to be evaluated.

Influences of High School Physical Learning Environments on Students' Anxiety in China

BACKGROUND

High school students are at an increased risk of developing generalized anxiety disorder (GAD) due to significant pressure to achieve academic success.

AIM

Although it is known that a school's physical learning environment can influence students' GAD, there is limited research examining this relationship. To fill this knowledge gap, a cross-sectional study was conducted among 230 students from two high schools in China.

METHODS

A survey questionnaire captured students' GAD self-evaluations (dependent variables), perceptions/preferences of their school physical environment (independent variables), and social and personal conditions (confounding variables). Bivariate analysis showed that students' GAD scores were associated with multiple factors related to the learning environment, physical activities, and personal characteristics. The multivariate analysis examined the relationship between GAD scores and physical learning environment variables while controlling for confounding variables.

RESULTS

The results indicated that adequate lighting (B = -0.154, p = .029) and perceived effectiveness of using self-service cafeterias in reducing anxiety (B = -0.138, p = .044) were significantly associated with GAD scores.

CONCLUSIONS

These findings provide evidence for the importance of designing high schools with students' mental health in mind. Specifically, school administrators and designers should consider how to improve the physical learning environment by incorporating natural light, a self-service cafeteria, and spaces for physical activities to promote students' mental well-being.

Experimental study on the impact of indoor air quality on creativity by Serious Brick Play method

Companies are increasingly asking their employees to find creative solutions to their problems. However, the office environment may reduce an employee's creative potential. In this study, the role of indoor air quality parameters (PM2.5, TVOC, and CO2) in maintaining a creative environment (involving lateral thinking ability) was evaluated by Serious Brick Play (SBP), an adaptation of the LEGO Serious Play (LSP) framework. This study was conducted in a simulated office space with 92 participants over a period of 6 weeks. The SBP required participants to address a challenge by building using Lego bricks, and then describe the solution within a given timeframe. The creations and descriptions were then graded in terms of originality, fluency, and build. The results indicated that higher TVOC levels were significantly associated with lower-rated creative solutions. A 71.9% reduction in TVOC (from 1000 ppb), improves an individual's full creative potential by 11.5%. Thus, maintaining a low TVOC level will critically enhance creativity in offices.

A Neurophysiological Evaluation of Cognitive Load during Augmented Reality Interactions in Various Industrial Maintenance and Assembly Tasks

Augmented reality (AR) has been shown to improve productivity in industry, but its adverse effects (e.g., headaches, eye strain, nausea, and mental workload) on users warrant further investigation. The objective of this study is to investigate the effects of different instruction methods (i.e., HoloLens AR-based and paper-based instructions) and task complexity (low and high-demanding tasks) on cognitive workloads and performance. Twenty-eight healthy males with a mean age of 32.12 (SD 2.45) years were recruited in this study and were randomly divided into two groups. The first group performed the experiment using AR-based instruction, and the second group used paper-based instruction. Performance was measured using total task time (TTT). The cognitive workload was measured using the power of electroencephalograph (EEG) features and the NASA task load index (NASA TLX). The results showed that using AR instructions resulted in a reduction in maintenance times and an increase in mental workload compared to paper instructions, particularly for the more demanding tasks. With AR instruction, 0.45% and 14.94% less time was spent on low- and high-demand tasks, respectively, as compared to paper instructions. According to the EEG features, employing AR to guide employees during highly demanding maintenance tasks increased information processing, which could be linked with an increased germane cognitive load. Increased germane cognitive load means participants can better facilitate long-term knowledge and skill acquisition. These results suggested that AR is superior and recommended for highly demanding maintenance tasks since it speeds up maintenance times and increases the possibility that information is stored in long-term memory and encrypted for recalls.

Cognitive Load Assessment Scales in Simulation: Validity Evidence for a Novel Measure of Cognitive Load Types

INTRODUCTION

Cognitive load (CL) theory provides a framework to inform simulation instructional design. Reliable measures of CL types (intrinsic [IL], extraneous [EL], and germane load [GL]) in simulation are lacking. We developed the novel Cognitive Load Assessment Scales in Simulation (CLAS-Sim) and report validity evidence using Kane's framework.

METHODS

This quasi-experimental study tested the effect of a segmented/pause-and-debrief or standard/end-of-case-debrief intervention on pediatric residents' performance and self-rated CL in 2 complex- and simple-case simulations. After each simulation, participants completed 22 items measuring CL types. Three validity inferences were examined: scoring (instrument development and principal component analysis); generalization (internal consistency reliability of CL-component items across cases); and extrapolation [CLAS-Sim correlations with the single-item Paas scale, which measures overall CL; differences in primary task performance (high vs low); and discriminant validity of IL under different instructional-design conditions].

RESULTS

Seventy-four residents completed both simulations and postcase CLAS-Sim measures. The principal component analysis yielded 3 components: 4-item IL, 4-item EL, and 3-item GL scales (Cronbach's α, 0.68-0.77). The Paas scores correlated with CLAS-Sim IL and total CL scores in both cases ( rs range, 0.39-0.70; P ≤ 0.001). High complex-case performers reported lower IL and total CL (analyses of variance, each P < 0.001). In multivariate analyses of variance, CLAS-Sim IL, GL, and total CL varied across both cases by arm (each P ≤ 0.018); the segmented-debrief arm reported lower IL than the standard-debrief arm in both cases (each P ≤ 0.01).

CONCLUSIONS

The CLAS-Sim demonstrates preliminary validity evidence for distinguishing 3 CL types but requires further study to evaluate the impact of simulation-design elements on CL and learning.

A Pharmacy Drug Knowledge Assessment Pilot: Who Will Fly Farthest and What Downs the Plane?

OBJECTIVE

To evaluate the effectiveness of a sequenced drug knowledge pilot in third professional year students in a capstone course.

METHODS

A three-phase drug knowledge pilot was conducted in spring 2022. Students completed a total of thirteen assessments, including nine low-stakes quizzes, three formative tests, and a final summative comprehensive exam. Results from the previous year's cohort (historical control) who only completed a summative comprehensive exam were compared to the pilot (test group) results to assess effectiveness. The faculty spent over 300 h developing content for the test group.

RESULTS

The pilot group had a mean score of 80.9% on the final competency exam, which was one percent lower than the control group who had a less rigorous intervention. A sub-analysis was conducted that removed the students who failed (<73%) the final competency exam, and no significant difference in the exam score was found. One practice drug exam was found to be moderately correlated and significant (r = 0.62) with the final knowledge exam performance in the control. The number of attempts on the low-stakes assessments had a low correlation with the final exam score in the test group compared to the control (r = 0.24).

CONCLUSION

The results of this study suggest a need to further investigate the best practices for knowledge-based drug characteristic assessments.

Investigating Students' Satisfaction with Online Collaborative Learning During the COVID-19 Period: An Expectation-Confirmation Model

The recent outbreak of COVID-19 posed discontinuous disruption to traditional learning modes worldwide. In order to keep social distance, online collaborative learning has become a necessity during the pandemic. However, our understanding of students' well-being and satisfaction with online collaborative learning is limited, especially during the COVID-19 period. Leveraging expectation confirmation theory, this study focuses on the triggers and inhibitors of students' cognitive load during online collaborative learning process and their subsequent satisfaction with the learning mode during the pandemic. We used a mixed-method approach in this study. We conducted a qualitative study with interview data and a quantitative study with surveys. The results indicate several psychological and cognitive antecedents of students' cognitive load during online collaborative learning. Findings also indicate that a high level of cognitive load will decrease students' perceived usefulness of the online learning platform and expectation confirmation, thus leading to a low level of satisfaction with online collaborative learning. This study can provide theoretical and practical implications for a better understanding of online student groups' satisfaction with online collaborative learning during the COVID-19 period.

Positive effects of indoor environmental conditions on students and their performance in higher education classrooms: A between-groups experiment

This study explores if multiple alterations of the classrooms' indoor environmental conditions, which lead to environmental conditions meeting quality class A of Dutch guidelines, result in a positive effect on students' perceptions and performance. A field study, with a between-group experimental design, was conducted during the academic course in 2020-2021. First, the reverberation time (RT) was lowered in the intervention condition to 0.4 s (control condition 0.6 s). Next, the horizontal illuminance (HI) level was raised in the intervention condition to 750 lx (control condition 500 lx). Finally, the indoor air quality (IAQ) in both conditions was improved by increasing the ventilation rate, resulting in a reduction of carbon dioxide concentrations, as a proxy for IAQ, from ~1100 to <800 ppm. During seven campaigns, students' perceptions of indoor environmental quality, health, emotional status, cognitive performance, and quality of learning were measured at the end of each lecture using questionnaires. Furthermore, students' objective cognitive responses were measured with psychometric tests of neurobehavioural functions. Students' short-term academic performance was evaluated with a content-related test. From 201 students, 527 responses were collected. The results showed that the reduction of the RT positively influenced students' perceived cognitive performance. A reduced RT in combination with raised HI improved students' perceptions of the lighting environment, internal responses, and quality of learning. However, this experimental condition negatively influenced students' ability to solve problems, while students' content-related test scores were not influenced. This shows that although quality class A conditions for RT and HI improved students' perceptions, it did not influence their short-term academic performance. Furthermore, the benefits of reduced RT in combination with raised HI were not observed in improved IAQ conditions. Whether the sequential order of the experimental conditions is relevant in inducing these effects and/or whether improving two parameters is already beneficial, is unknown.

Effect of Technology Acceptance on Blended Learning Satisfaction: The Serial Mediation of Emotional Experience, Social Belonging, and Higher-Order Thinking

This study explored the relationship between technology acceptance and learning satisfaction in the context of blended learning, with a particular focus on the mediating effects of online behaviors, emotional experience, social belonging, and higher-order thinking. A total of 110 Chinese university students participated in this study and completed a questionnaire at the end of 11 weeks of blended learning. The results demonstrate that technology acceptance directly and indirectly relates to blended learning satisfaction. The mediation analysis further revealed two significant mediating pathways from technology acceptance to blended learning satisfaction: one through higher-order thinking, and the other through serial mediation of emotional experience, social belonging, and higher-order thinking. Moreover, there was no significant mediating effect of online learning behaviors on blended learning satisfaction. Based on these results, we have proposed practical implications for improving blended learning practice to promote learner satisfaction. These results contribute to our understanding of blended learning as an integrated construct under the triadic interplay of technical environment, learning behaviors, and individual perceptions.

Implications of Entrustable Professional Activities for Motivation and Learning

INTRODUCTION

This study sought to explore the experience of entrustable professional activity-based assessment and its effect on self-determination, a well-supported measure of motivation. The goal was to understand EPA-based assessment's implications for student motivation, learning, and wellbeing.

METHODS

A qualitative case study design was utilized through a standardized simulation activity with EPA-based assessment. An analysis of interviews and reflection journals was completed by the coding of emergent themes and significant statements with a subsequent thematic analysis framed in self-determination theory (SDT).

RESULTS

Entrustment was found to be an affectively and interpersonally impactful metric that provided the learner with a clear understanding of clinical performance. Quality entrustment feedback supported participants' sense of competence and increased their confidence in their ability to be autonomous as well as a valuable part of the healthcare team.

DISCUSSION

EPAs appeared to support learners' sense of competence and to provide a bridge to support autonomy and the ability to relate to others. To the extent that entrustment supported learners' sense of competence, other SDT propositions could be subsequently bolstered as well. Self-determination and intrinsic motivation were uniquely supported by EPA-based assessment, if implemented effectively. Further research is needed to better define effective implementation, faculty development, and feedback strategies.

Cognitive Load Management: An Invaluable Tool for Safe and Effective Surgical Training

This article highlights the importance of considering Cognitive Load (CL) and Cognitive Load Theory (CLT) during surgical training, focusing on the acquisition of intra-operative skills. It describes the basis of CLT with the overarching aim of describing CLT-based techniques to enhance current training strategies and surgical performance, many of which are instinctively already employed in surgical practice. Currently, methods of feedback and assessment are imperfect - typically subjective, unsystematic, opportunistic, or retrospective, and at risk of human bias. Surgical Sabermetrics, the advanced analytics of surgical and audio-visual data, aims to enhance this feedback by providing objective, real-time, digital-based feedback. This article introduces the benefit of real-time measurement of CL to enhance feedback and its applications to surgical performance that follow the ethos of Surgical Sabermetrics.¹ The 2022 theme for ICOSET was "Making it Better." Cognitive Load and Surgical Sabermetrics principles provide tools to make Surgical training better, with the goal of higher quality care for patients.

A Systematic Review of Cost, Effort, and Load Research in Information Search and Retrieval, 1972-2020

During the Information Search and Retrieval (ISR) process, user-system interactions such as submitting queries, examining results, and engaging with information, impose some degree of demand on the user’s resources. Within ISR, these demands are well recognised, and numerous studies have demonstrated that the Cost, Effort, and Load (CEL) experienced during the search process are affected by a variety of factors. Despite this recognition, there is no universally accepted definition of the constructs of CEL within the field of ISR. Ultimately this has led to problems with how these constructs have been interpreted and subsequently measured. This systematic review contributes a synthesis of literature, summarising key findings relating to how researchers have been defining and measuring CEL within ISR over the past 50 years. After manually screening 1,109 articles, we detail and analyse 91 articles which examine CEL within ISR. The discussion focuses on comparing the similarities and differences between CEL definitions and measures before identifying the limitations of the current state of the nomenclature. Opportunities for future research are also identified. Going forward, we propose a CEL taxonomy that integrates the relationships between CEL and their related constructs, which will help focus and disambiguate future research in this important area.

Virtual Reality Head-Mounted Displays in Medical Education: A Systematic Review

SUMMARY STATEMENT

Simulation-based training using virtual reality head-mounted displays (VR-HMD) is increasingly being used within the field of medical education. This article systematically reviews and appraises the quality of the literature on the use of VR-HMDs in medical education. A search in the databases PubMed/MEDLINE, Embase, ERIC, Scopus, Web of Science, Cochrane Library, and PsychINFO was carried out. Studies were screened according to predefined exclusion criteria, and quality was assessed using the Medical Education Research Study Quality Instrument. In total, 41 articles were included and thematically divided into 5 groups: anatomy, procedural skills, surgical procedures, communication skills, and clinical decision making. Participants highly appreciated using VR-HMD and rated it better than most other training methods. Virtual reality head-mounted display outperformed traditional methods of learning surgical procedures. Although VR-HMD showed promising results when learning anatomy, it was not considered better than other available study materials. No conclusive findings could be synthesized regarding the remaining 3 groups.

Designing a Co-creation System for the Development of Work-process-related Learning Material in Manufacturing

The increasing digitalization and automatization in the manufacturing industry as well as the need to learn on the job has reinforced the need for much more granular learning, which has not yet impacted the design of learning materials. In this regard, granular learning concepts require situated learning materials to support self-directed learning in the workplace in a targeted manner. Co-creation approaches offer promising opportunities to support employees in the independent design of such situated learning materials. Using an action-design research (ADR) approach, we derived requirements from co-creation concepts and practice by conducting focus group workshops in manufacturing and vocational training schools to develop design principles for a co-creation system that supports employees through the creation process of work-process-related learning material. Consequently, we formulate four design principles for the design of a collaborative learning and qualification system for manufacturing. Using an innovative mixed methods approach, we validate these design principles and design features to demonstrate the success of the developed artifact. The results provide insights regarding the design of a co-creation system to support learners in the co-creation of learning material with the consideration of cognitive load (CL). Our study contributes to research and practice by proposing novel design principles for supporting employees in peer creation processes. Furthermore, our study reveals how co-creation systems can support the collaborative development of learning materials in the work process.

The Role of a Restorative Resource in the Academic Context in Improving Intrinsic and Extrinsic Motivation and Flow within the Job Demands-Resources Model

The perceived quality of the learning environment may influence both motivation and concentration. Little is known about how perceived characteristics of the learning environment, and specifically sub-dimensions of Perceived Restorativeness (being away, fascination, compatibility, and extent), can promote these positive effects in an academic context. We addressed, through a correlational study, the possibility that the characteristics of learning environments may promote concentration and involvement in activity (i.e., flow) via intrinsic and extrinsic motivation for academic study within the job demands-resources model. A total of 165 Italian university psychology classes in a 3-year degree course from two different universities context completed an online questionnaire made up of the construct considered in this study. Results in the hierarchical multivariate regression analyses confirm that the restorative quality of learning environments (i.e., being away, compatibility, extent) is positively correlated with flow. However, there is a non-significant relationship between extent and flow. Regression analyses show a significant indirect effect of compatibility, both through intrinsic and extrinsic student motivation. Furthermore, the results confirm a significant indirect effect of extent through intrinsic motivation and being away, and fascination through Extrinsic motivation. Furthermore, intrinsic motivation is a full mediator between the extent and flow relationship. The results underline the importance of considering the restorative quality of the environment for improving place design, concentration, and student learning motivation.

A study on the correlation between seat selection and interaction preference in virtual-reality fusion simulation experiment

In order to explore the correlation between students’ seat choice and interaction preference in the open gamification scenario, an experiment has been carried out on the platform of provincial virtual simulation experiment teaching center of a university, and tested the relationship between absolute distance, seat type, workstation type, and students’ interaction preference. The results show that in the virtual-reality fusion gamification scenario where students can move freely: (1) The inner circle students can stimulate the outer circle students’ willingness to invest in learning. (2) The task attribute and the seat distribution of the group may lead to the difference of students’ interaction preference. (3) Students are more likely to learn knowledge and skills by interacting with “people” rather than “object.” (4) Gender and major influence students’ experience of participating in gamified teaching. The results confirm that the interactive engagement effect of location does exist in immersive virtual-reality fusion gamification teaching scenario, and suggestions are put forward to adjust the effect of location through instructional design and teacher intervention.

Augmented reality with algorithm animation and their effect on students' emotions

Algorithm animations are a resource that assists in learning algorithms by visually displaying the behavior of an algorithm at a higher level of abstraction than source code. On the other hand, augmented reality is a technology that allows extending visible reality in a mobile device, which can result in greater emotional well-being for the student. However, it is not clear how to integrate algorithm animations with augmented reality. The article makes two contributions to this concern. On the one hand, we describe an architecture that allows generating interactive algorithm animations, integrating them appropriately in the context of immersive augmented reality. This way the user can watch the source code of the algorithm, augmented with textual explanations, visualizations and animations of its behavior. We illustrate the use of the architecture by instantiating it to the well-known Dijkstra's algorithm, resulting in an augmented reality tool that generates text, 2D and 3D visualizations. On the other hand, the influence of the tool on the user's emotions has been studied by conducting an experience with face-to-face and online students. The results show that, with the joint use of augmented reality and visualizations, the students: experienced significantly more positive than negative emotions, experienced more agitation and stimulation than inactivity or calm, enjoyed as much as they expected, and their feeling of boredom decreased during the experience. However, students felt anxiety from the beginning and it increased with the use of augmented reality. The study also found that the face-to-face or online learning model influences emotions and learning outcomes with augmented reality.

"Seeing and Being Seen" or Just "Seeing" in a Smart Classroom Context When Videoconferencing: A User Experience-Based Qualitative Research on the Use of Cameras

This research examines the form in which undergraduates use video cameras during videoconferencing class sessions in a Smart Classroom context and, more specifically, the reasons why a considerable number of students opt to turn off their cameras when videoconferencing during the sessions while others keep them on. The study was carried out in an institution that had previously switched from face-to-face teaching to an Emergency Remote Teaching solution, initially adopted in 2019-2020 to cope with the COVID-19 pandemic restrictions. Findings suggest that using cameras when videoconferencing is associated with increasing and enhancing the interaction between the student and the rest of the class, although not all students agreed with this conclusion. In addition, having the video cameras switched fomented socialization and improved the overall online learning experience for students. However, the surveyed students pointed out diverse negative elements, such as why they had to turn on their personal cameras, privacy concerns, and limitations derived from the available technology infrastructure, in addition to other factors such as distractions, anxiety, and cognitive load. This work discusses how these elements can influence the well-being and the user experience of the students, both positively and negatively.

Influence of the COVID-19 Pandemic on Learning Preferences and Perspectives of Generation Y and Z Students in Dental Education

Objectives

For the first time in history, the COVID‐19 pandemic required students at The University of Texas School of Dentistry (UTSD) to move to remote education. Based on a literature review, it was assumed that younger generations of students would prefer virtual teaching models over in‐classroom formats. The purpose of this study is to assess students' perspectives of remote learning during COVID‐19 in dental education relative to their generation and programme.

Methods

An electronic survey was administered to all UTSD dental and dental hygiene students via Qualtrics. The survey collected information on demographics, pre‐pandemic learning preferences, remote learning experiences during the pandemic, and a free response section. Descriptive statistics and Fisher's exact test were used to analyse data.

Results

The survey received a 60% response rate (n = 290). Over 95% of respondents belonged to Generations Y and Z. There were no significant differences in responses between generations. However, significant differences in responses between programmes arose with more dental hygiene students agreed that they liked learning in a classroom setting compared to dental students (p < 0.01). Significantly more dental students agreed that they stayed organized, were less stressed, and felt that the transition to online learning was easy compared to dental hygiene students (p < 0.01).

Conclusion

Although the majority of students surveyed belong to Generations Y and Z, there are still preferences for traditional, in‐person learning. Both cohorts recognized the benefits and challenges of distance learning, and the findings from this study shed light on how students are handling remote learning in dental education.

The Impact of Physical Environment on the Cognitive Function of the Elderly: A Scoping Review of Cohort Studies

This review examined whether the physical environment can change the cognitive function of the elderly and categorized the specific environmental types. Four databases, CINAHL, Embase, PubMed, and PsycINFO, were searched for relevant literature published as of December 2020. The framework used was proposed by Arksey and O’Malley, which includes a 5-stage review process. A total of 12 studies were examined. The physical environments with similar characteristics, among all the environmental elements, were grouped together into 4 categories: residential density and road connectivity, limited living space, urban/rural, and care facilities. Residential density and road connectivity, limited living space, and care facilities were found to have a significant effect on the cognitive function of the elderly. However, there was no significant effect on the cognitive function of the elderly when comparing the urban and rural environments. Although studies on environments that affect the cognitive function of the elderly are still ongoing, the ones analyzing specific environments in detail are insufficient. With the increasing importance of the role played by the environment in the cognitive impairment of the elderly, detailed studies on specific environments among the various environmental factors surrounding the elderly, such as this study, should be conducted more actively.

A Synthetic Review of Cognitive Load in Distance Interpreting: Toward an Explanatory Model

Distance Interpreting (DI) is a form of technology-mediated interpreting which has gained traction due to the high demand for multilingual conferences, live-streaming programs, and public service sectors. The current study synthesized the DI literature to build a framework that represents the construct and measurement of cognitive load in DI. Two major areas of research were identified, i.e., causal factors and methods of measuring cognitive load. A number of causal factors that can induce change in cognitive load in DI were identified and reviewed. These included factors derived from tasks (e.g., mode of presentation), environment (e.g., booth type), and interpreters (e.g., technology awareness). In addition, four methods for measuring cognitive load in DI were identified and surveyed: subjective methods, performance methods, analytical methods, and psycho-physiological methods. Together, the causal factors and measurement methods provide a multifarious approach to delineating and quantifying cognitive load in DI. This multidimensional framework can be applied as a tool for pedagogical design in interpreting programs at both the undergraduate and graduate levels. It can also provide implications for other fields of educational psychology and language learning and assessment.

A Cross-Country Comparison of Students’ Graphs Understanding and Perceived Mental Effort

Students’ graph understanding was chosen for the research because teachers, especially physics teachers, tend to use graphs as a second language, assuming that their students can extract most of the information from them. This research aims to determine the differences between Serbian and North Macedonian students’ graph understanding of kinematics and their perceived mental effort. Differences in physics curricula in the Republic of Serbia and Republic of North Macedonia are taken into account and compared as well as students’ achievement on the TUG-K knowledge test to find explanations of potential differences and guidelines for change in the approaches to physics teaching. The sample includes 630 first-grade grammar school students (313 students from Serbia and 317 from North Macedonia) from randomly selected classes. Mann–Whitney U-test determined possible differences in student achievement and perceived mental effort. The main results indicate a difference in students perceived mental effort. North Macedonian students perceived less mental effort than Serbian ones, which leads to higher instructional efficiency of teaching approaches applied in North Macedonia than in Serbia. Based on the results, the recommendation for improving the Serbian education system lies in reducing mental effort through efficient allocation of teaching hours.

Objective Measurement of Learners' Cognitive Load During Simulation-Based Trauma Team Training: A Pilot Study

INTRODUCTION

Literature has shown cognitive overload which can negatively impact learning and clinical performance in surgery. We investigated learners' cognitive load during simulation-based trauma team training using an objective digital biomarker.

METHODS

A cross-sectional study was carried out in a simulation center where a 3-h simulation-based interprofessional trauma team training program was conducted. A session included three scenarios each followed by a debriefing session. One scenario involved multiple patients. Learners wore a heart rate sensor that detects interbeat intervals in real-time. Low-frequency/high-frequency (LF/HF) ratio was used as a validated proxy for cognitive load. Learners' LF/HF ratio was tracked through different phases of simulation.

RESULTS

Ten subjects participated in 12 simulations. LF/HF ratios during scenario versus debriefing were compared for each simulation. These were 3.75 versus 2.40, P < 0.001 for scenario 1; 4.18 versus 2.77, P < 0.001 for scenario 2; and 4.79 versus 2.68, P < 0.001 for scenario 3. Compared to single-patient scenarios, multiple-patient scenarios posed a higher cognitive load, with LF/HF ratios of 3.88 and 4.79, P < 0.001, respectively.

CONCLUSIONS

LF/HF ratio, a proxy for cognitive load, was increased during all three scenarios compared to debriefings and reached the highest levels in a multiple-patient scenario. Using heart rate variability as an objective marker of cognitive load is feasible and this metric is able to detect cognitive load fluctuations during different simulation phases and varying scenario difficulties.

A Schema-Based Instructional Design Model for Self-Paced Learning Environments

Although research on schema has been widely investigated for the past decades, little research has addressed the development of a systematic instructional design theory using schema principles and processes. This study proposes a systematic schema-based instructional design model, including general and schema analysis, schema-based design, and development processes and techniques for evaluating a learner’s acquired schema. By synthesizing empirical studies, this study comprehensively reviews literature on schema and foundational principles for learning. The goal of the study is to enrich the knowledge base of schema-based instructional design for different learning environments. Thus, the study is concluded by a discussion on how to utilize a schema-based instructional design for self-paced learning environments with additional implications and further recommendations.

Sharing the Bandwidth in Cognitively Overloaded Teams and Systems: Mechanistic Insights from a Walk on the Wild Side of Clinical Reasoning

IssuePrevious work from the diagnostic error literature has provided indirect evidence that faulty clinical reasoning may be the most frequent cause of error when attaching a diagnostic label. The precise mechanisms underlying diagnostic error are unclear and continue to be subject to considerable theory informed debate in the clinical reasoning literature. Evidence: We take a theoretical approach to merging these two worlds of literature by first zooming out using distributed cognition as a social cognitive lens (macro theory) to develop a view of the process and outcome of clinical reasoning occurring in the wild - defined as the integrated clinical workplace - the natural habitat of clinicians working within teams. We then zoom in using the novel combination of cognitive load theory and distributed cognition to provide additional theoretical insights into the potential mechanisms of error. Implications: Through the lenses of distributed cognition and cognitive load theory, we can begin to prospectively investigate how cognitive overload is represented and shared within interprofessional teams over time and space and how this influences clinical reasoning performance and leads to error. We believe that this work will help teams manage cognitive load and prevent error.

Physical home learning environments for digitally-supported learning in academic continuing education during COVID-19 pandemic

Since the outbreak of the COVID-19 pandemic in 2020, digital technologies for distance learning have been used in educational institutions worldwide, raising issues about social implications, technological development, and teaching and learning strategies. While disparities regarding access to technical equipment and the internet ('the digital divide') have been the subject of previous research, the physical learning environment of learners participating in online learning activities has hardly been investigated. In this study, the physical-spatial conditions of learning environments, including technical equipment for distance learning activities and their influence on adult learners in academic continuing education during initial COVID-19 restrictions, were examined. Data were collected with an online survey sent to all students enrolled in an Austrian continuing education university, together with a small number of semi-structured interviews. A total of 257 students participated in the survey during the 2020 summer semester. Our findings provide insights in two infrequently-studied areas in learning environment research: the physical learning environment for online learning and the learning environment in academic continuing education. The study illustrates that students in academic continuing education have spacious living conditions and almost all the equipment necessary for digitally-supported learning. According to gender and household structure, significant differences were found regarding technical equipment, ergonomic furniture and availability of a dedicated learning place. In their learning sessions during the restrictions, students reported low stress levels and positive well-being. The more that they perceived that their physical learning environment was meeting their needs, the higher were their motivation and well-being and the lower was their stress. Their learning experience was further improved by the extent to which they had a separate and fixed learning place that did not need to be coordinated or shared with others. The study contributes to the literature on creating conducive learning environments for digitally-supported online learning for adult learners.

Exploring the relationship between emotion and cognitive load types during patient handovers

Cognitive Load Theory has emerged as an important approach to improving instruction in the health professions workplace, including patient handovers. At the same time, there is growing recognition that emotion influences learning through numerous cognitive processes including motivation, attention, working memory, and long-term memory. This study explores how emotion influences the cognitive load experienced by trainees performing patient handovers. From January to March 2019, 693 (38.7%) of 1807 residents and fellows from a 24-hospital health system in New York city completed a survey after performing a handover. Participants rated their emotional state and cognitive load. The survey included questions about features of the learner, task, and instructional environment. The authors used factor analysis to identify the core dimensions of emotion. Regression analyses explored the relationship between the emotion factors and cognitive load types. Two emotion dimensions were identified representing invigoration and tranquility. In regression analyses, higher levels of invigoration, tranquility, and their interaction were independently associated with lower intrinsic load and extraneous load. The interaction of invigoration and tranquility predicted lower germane load. The addition of the emotion variables to multivariate models including other predictors of cognitive load types significantly increased the amount of variance explained. The study provides a model for measuring emotions in workplace learning. Because emotion appears to have a significant influence on cognitive load types, instructional designers should consider strategies that help trainees regulate emotion in order to reduce cognitive load and improve learning and performance.

The Influence of Learning Styles on Perception and Preference of Learning Spaces in the University Campus

Good academic performance will occur when learning spaces match or support individual preference and needs. This effect depends on environmental characteristics and individual attributes. Learning styles (LSs) have been used as a tool to capture the behavioral and psychological characteristics of learners in the process of learning activities, which provide instructions to address their learning needs. However, few have focused on the perceptual characteristics of learning space from the view of distinct learning styles. The research aims to identify which kinds of learning spaces in university campus have been preferred by students with different learning styles respectively and the spatial characteristics which have significant influence on the distinct evaluation results; the research consists of 178 college students’ LSs measurement conducted by the Index of Learning Styles questionnaire and their subjective assessment to five typical learning spaces obtained by 5-point Likert-type scale. Then, the key spatial influencing factors were identified by the focus group interviews; the results firstly ranked the learning spaces according to their satisfaction evaluation and restorative potential. The self-study rooms are rated highest, followed by professional classroom, traditional classroom, and multimedia classroom. Then, two dimensions of learning styles were proved as having considerable effects on perception. Specifically, there are significant differences between visual and verbal learners’ evaluations of multimedia classrooms and traditional classrooms, and between global and sequential learners’ evaluations of multimedia classrooms, informal learning spaces, and learning buildings. The other two dimensions including perceiving and remembering have no obvious impacts on learners’ perception of any learning spaces. At last, the important influence factors of perceptions of five typical learning spaces were identified, respectively, and their different effects on various groups were discussed. For example, the serious atmosphere in traditional classrooms was regarded as a motivation for sensing learners but a stress for intuitive learners. The studies emphasize the perceptual difference on learning space in terms of students’ unique learning styles and key points for each kind of learning space with regard to satisfaction of personalized needs. However, before it can be used by designers as tools, more research is needed.

Working With Environmental Noise and Noise-Cancelation: A Workload Assessment With EEG and Subjective Measures

As working and learning environments become open and flexible, people are also potentially surrounded by ambient noise, which causes an increase in mental workload. The present study uses electroencephalogram (EEG) and subjective measures to investigate if noise-canceling technologies can fade out external distractions and free up mental resources. Therefore, participants had to solve spoken arithmetic tasks that were read out via headphones in three sound environments: a quiet environment (no noise), a noisy environment (noise), and a noisy environment but with active noise-canceling headphones (noise-canceling). Our results of brain activity partially confirm an assumed lower mental load in no noise and noise-canceling compared to noise test condition. The mean P300 activation at Cz resulted in a significant differentiation between the no noise and the other two test conditions. Subjective data indicate an improved situation for the participants when using the noise-canceling technology compared to “normal” headphones but shows no significant discrimination. The present results provide a foundation for further investigations into the relationship between noise-canceling technology and mental workload. Additionally, we give recommendations for an adaptation of the test design for future studies.

Virtual Interviews and Their Effect on Cognitive Load for Graduate Medical Education Applicants and Programs

The impact of coronavirus disease (COVID-19) has dramatically affected virtually all aspects of health care use, including patient care, research, and education. Among the groups affected were prospective applicants to graduate medical education training programs. To ensure a safe and equitable process for residency and fellowship application, multiple accrediting bodies strongly recommended that training programs conduct fellowship and residency interviews in a virtual format. With little experience in virtual interviewing, most programs, including ours, were compelled to make substantial changes to the traditional interview format. We present some of the unanticipated challenges we experienced with virtual interviewing in the context of cognitive load theory. We use cognitive load theory to highlight why the challenges existed. We also offer practical tips to minimize the cognitive load experienced with virtual interviewing so that trainees and programs alike derive maximal benefit when using virtual communication platforms.

The Physical Learning Environment of Online Distance Learners in Higher Education - A Conceptual Model

Online distance learning is offered not only in post-secondary distance education institutions but in traditional universities as well. With advances in mobile and wireless technologies, completing academic studies anywhere anytime should become feasible. Research in distance education and online learning has focused on computer-mediated communication, instructional design, learner characteristics, educational technology, and learning outcomes. However, little attention has been given to where exactly learners do their learning and studying and how the physical and social aspects of the physical environment within which the online learner is physically embedded (e.g., the home) supports and constrains learning activities. In this paper, the author proposes a conceptual model for understanding the role that the physical environment plays in online distance learning in higher education, drawing on theories and research in environmental psychology, online learning, telework and mobile work, and higher education. Several gaps in research are identified, and suggestions for future research are proposed.

Effects of Neuro-Cognitive Load on Learning Transfer Using a Virtual Reality-Based Driving System

Understanding the ways different people perceive and apply acquired knowledge, especially when driving, is an important area of study. This study introduced a novel virtual reality (VR)-based driving system to determine the effects of neuro-cognitive load on learning transfer. In the experiment, easy and difficult routes were introduced to the participants, and the VR system is capable of recording eye-gaze, pupil dilation, heart rate, as well as driving performance data. So, the main purpose here is to apply multimodal data fusion, several machine learning algorithms, and strategic analytic methods to measure neurocognitive load for user classification. A total of ninety-eight (98) university students participated in the experiment, in which forty-nine (49) were male participants and forty-nine (49) were female participants. The results showed that data fusion methods achieved higher accuracy compared to other classification methods. These findings highlight the importance of physiological monitoring to measure mental workload during the process of learning transfer.

Mobile Sensing with Smart Wearables of the Physical Context of Distance Learning Students to Consider Its Effects on Learning

Research shows that various contextual factors can have an impact on learning. Some of these factors can originate from the physical learning environment (PLE) in this regard. When learning from home, learners have to organize their PLE by themselves. This paper is concerned with identifying, measuring, and collecting factors from the PLE that may affect learning using mobile sensing. More specifically, this paper first investigates which factors from the PLE can affect distance learning. The results identify nine types of factors from the PLE associated with cognitive, physiological, and affective effects on learning. Subsequently, this paper examines which instruments can be used to measure the investigated factors. The results highlight several methods involving smart wearables (SWs) to measure these factors from PLEs successfully. Third, this paper explores how software infrastructure can be designed to measure, collect, and process the identified multimodal data from and about the PLE by utilizing mobile sensing. The design and implementation of the Edutex software infrastructure described in this paper will enable learning analytics stakeholders to use data from and about the learners’ physical contexts. Edutex achieves this by utilizing sensor data from smartphones and smartwatches, in addition to response data from experience samples and questionnaires from learners’ smartwatches. Finally, this paper evaluates to what extent the developed infrastructure can provide relevant information about the learning context in a field study with 10 participants. The evaluation demonstrates how the software infrastructure can contextualize multimodal sensor data, such as lighting, ambient noise, and location, with user responses in a reliable, efficient, and protected manner.

Validation of Cognitive Load During Inquiry-Based Learning With Multimedia Scaffolds Using Subjective Measurement and Eye Movements

Subject-method barriers and cognitive load (CL) of students have a particular importance in the complex learning process of scientific inquiry. In this work, we investigate the valid measurement of CL as well as different scaffolds to reduce it during experimentation. Specifically, we examine the validity of a subjective measurement instrument to assess CL [in extraneous cognitive load (ECL), intrinsic cognitive load, and germane cognitive load (GCL)] during the use of multimedia scaffolds in the planning phase of the scientific inquiry process based on a theoretical framework of the CL theory. The validity is analyzed by investigating possible relationships between causal (e.g., cognitive abilities) and assessment (e.g., eye-tracking metrics) factors in relation to the obtained test scores of the adapted subjective measurement instrument. The study aims to elucidate possible relationships of causal factors that have not yet been adequately investigated in relation to CL. Furthermore, a possible, still inconclusive convergence between subjective test scores on CL and objectively measured indicators will be tested using different eye-tracking metrics. In two studies (n=250), 9th and 11th grade students experimentally investigated a biological phenomenon. At the beginning of the planning phase, students selected one of four multimedia scaffolds using a tablet (Study I: n=181) or a computer with a stationary eye-tracking device (Study II: n=69). The subjective cognitive load was measured via self-reports using a standardized questionnaire. Additionally, we recorded students’ gaze data during learning with the scaffolds as objective measurements. Besides the causal factors of cognitive-visual and verbal abilities, reading skills and spatial abilities were quantified using established test instruments and the learners indicated their representation preference by selecting the scaffolds. The results show that CL decreases substantially with higher grade level. Regarding the causal factors, we observed that cognitive-visual and verbal abilities have a significant influence on the ECL and GCL in contrast to reading skills. Additionally, there is a correlation between the representation preference and different types of CL. Concerning the objective measurement data, we found that the absolute fixation number is predictive for the ECL. The results are discussed in the context of the overall methodological research goal and the theoretical framework of CL.