| The problem addressed in this study is that even though it has been demonstrated that having too high or too low of a cognitive load placed on learners during a clinical simulation activity can negatively affect learner performance during that activity, researchers admit that it is not yet clear how various components (i.e. instructor, equipment, fidelity, etc.) within the simulation activity affect learner cognitive load (Fraser, Ma, Teteris, Baxter, et al., 2012; Schlairet et al., 2015). The purpose of this study was to determine if there was a difference in cognitive load between learners going through simulation scenarios that were remotely facilitated (instructor not in the room) and those that had their scenarios locally facilitated (instructor in the room), if there was a difference in communication behavior between the two conditions, and if there was a relationship between communication behavior and learner cognitive load. This study employed a convergent-parallel mixed-methods design using a sample of healthcare providers going through their Pediatric Advanced Life Support certification skills checkoff. Participants in each session were given a set of standardized simulation scenarios that were video recorded and later analyzed. Following their scenarios, participants were administered a survey that measured their cognitive load. The results indicated participants in the remote facilitation group experienced higher cognitive load that those in the local group. Analysis of the video data indicated that locally facilitated scenarios had a higher degree of instructor-initiated communication and less intra-group communication that those in the remote facilitation group. Thus, having an instructor in the room during a scenario had a negative effect on team communication, and remote facilitation should be considered when group communication is part of the learning objectives. Thus, it is recommended facilitators who witness a lessening of intra-group communication during a scenario should consider the possibility that the cognitive load of their learners is increasing. |
