Teaching the technical performance of bronchoscopy to residents in a step-wise simulated approach: factors supporting learning and impacts on clinical work – a qualitative analysis

Background The ability to perform a bronchoscopy is a valuable clinical skill for many medical specialities. Learning this skill is demanding for residents, due to the high cognitive load. Lessons learned from cognitive load theory might provide a way to facilitate this learning. The aim of this study was to investigate residents’ perception of factors that support and hinder learning, as well as outcome and acceptance of a workshop on flexible bronchoscopy. Methods Three half-day workshops were designed to teach 12 residents the basics of handling a flexible bronchoscope. They consisted of four phases that alternated between short theoretical aspects and longer practical situations. The practical phases focussed initially on manoeuvring a bronchoscope through holes in panels inside a box, and then on examination and practice using a three-dimensional printed model of the bronchial tree. Afterwards, three audio- and video-recorded focus groups were conducted, transcribed and coded, and underwent reflexive thematic analysis. Results Analysis of the focus groups defined two themes: (1) factors that supported a safe and positive learning environment were optimised for intrinsic load, simulated setting, absence of pressure, dyad practice (working in pairs), small group sizes and playful learning; and (2) impacts on clinical work were perceived as high levels of learning and improved patient safety. The residents did not report factors that hindered their learning. Some suggestions were made to improve the set-up of the wooden box. Conclusions The half-day workshop was designed according to several factors, including cognitive load theory in a simulated setting, and creation of a safe and positive learning environment. The residents perceived this as supporting learning and patient safety. Further studies can be designed to confirm these results in a quantitative setting. Trial registration This study was not interventional, therefore was not registered.

Applying Constructivism in Neurodiverse Classrooms

Cognitive development theories differ on how young students can meaningfully process new information and retain that information for future knowledge-building through scaffolding within their zone of proximal development. More traditional theories like the cognitive load theory adhere to the rote memorization approach by categorizing students as passive learners and the teachers as initiators who provide information in a structured, often rigid format, to be stored and retrieved for future application using their working memory. In contrast, the more progressive theories, like constructivism, are premised on the belief that students should proactively initiate their own learning while teachers act more as facilitators. The current trend in government policy under ESSA is to embrace the latter approach in the classroom, which is also more inclusive of all types of students, especially neurodiverse students. Moreover, teachers can utilize the wider range of assistive technology tools to accommodate and support their students’ unique learning styles.

Cognitive Load Theory: An Applied Reintroduction for Special and General Educators

There are numerous reasons why students with disabilities struggle in school. A key reason is professionals in the field may not pay enough attention to students’ overwhelmed cognitive capacity. Cognitive load theory explains that all humans have limited capacity at any given time to use their auditory, visual, and tactile inputs (independently or collectively) to acquire new information and store it in long-term memory. When available cognition is overwhelmed – which can be caused by any number of reasons – learning cannot occur. In this article, we introduce the key aspects of cognitive load theory and give specific examples of how special educators can use this information to shape their instruction to support students’ unique needs.

The Instructional Design of Chinese Characters’ Stroke Order Motion Graphics Based on Cognitive Load Theory

This research aims to develop stroke order motion graphics for Chinese characters to solve the problem of memorising Chinese characters’ stroke order in the learning process. This research adopted cognitive load theory and the ADDIE model as an instructional design process guide. Herbart’s four-stage teaching method is used as a guide for the motion graphics presentation module. Based on the characteristics of Malaysian students who learn Chinese as their second language, motion graphics for Chinese characters’ stroke order learning were developed. The expert evaluation was conducted to identify problems, and modifications were done to improve the created prototype. A total of six Chinese characters’ stroke order motion graphics have been successfully developed. The result shows that cognitive load theory provides an effective solution for developing Chinese characters’ stroke order motion graphics. The ADDIE model also offered a significant direction for the instructional design process. In addition, to be more effective in Chinese character stroke order teaching, interface design must consider the relevant teaching effects of cognitive load theory. However, making the prototype in advance can avoid large-scale modifications in the later process. The successful development of the Chinese characters’ stroke order motion graphics allows teaching Chinese character stroke order in Malaysia to be carried out more effectively.

Effects of complexity-determined system pausing on learning from multimedia presentations

System pausing at pre-determined positions during multimedia presentations can enhance multimedia learning. However, the pause positions are usually set up based on the structure of the learning material (e.g., segmentation principle) rather than on the complexity of its different sections (as determined by levels of element interactivity, according to cognitive load theory). This study investigated the effectiveness of complexity-determined system pauses positioned either before or after complex (high element interactivity) sections of a slideshow multimedia presentation. The study adopted a single-factor between-subjects design and randomly assigned 128 undergraduates to four experimental conditions, namely (1) pausing before high element interactivity, (2) pausing after high element interactivity, (3) learner pausing and (4) no pausing. The research results revealed that complexity-determined system pausing approaches and learner pausing resulted in better test performance and instructional efficiency than the continuous presentation without pausing. The findings suggest that pauses allow students more time to deal with learning contents with high element interactivity, thus reducing potential cognitive overload and resulting in better performance compared with continuous presentation. However, no significant difference was found between the two types of system pausing and learner pausing in all measures.