How Does Cognitive Load Theory Relate to COVID-19?
Learners in clinical workplaces are at high risk of cognitive overload, and the COVID-19 pandemic compounds this risk. Constantly evolving complex information and changes to workplace practices contribute excessive intrinsic load. Increased demands on time, feelings of uncertainty and anxiety, and negative emotions related to stress introduce extraneous load. Without adjustments to work assignments and teaching practices, these factors can easily lead to cognitive overload. In addition to limiting learning, cognitive overload can harm performance and lead to negative patient outcomes. For example, consider a resident who is asked to admit a patient with a respiratory syndrome. Admitting such a patient might ordinarily be a simple task with low intrinsic load. However, the intrinsic load associated with admitting this patient will now be increased due to the additional steps of including COVID-19 in the differential diagnosis and considering COVID-19 related complications. The extraneous load may be elevated by personal protective equipment requirements, anxiety about contracting the coronavirus, and keeping track of current workflows and protocols for coronavirus testing. If these factors overwhelm the working memory, no capacity for germane load will remain and performance and learning may suffer. The resident may have wanted to learn about pulmonary findings in patients with COVID-19, but cognitive overload may prevent such learning. In his overwhelmed state, the resident may forget to order deep venous thrombosis prophylaxis, resulting in patient harm. Essentially, the resident is working harder and under greater stress, to the detriment of the resident’s learning and, potentially, patient care.