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Effects of low- versus high-fidelity simulations on the cognitive burden and performance of entry-level paramedicine students: a mixed-methods comparison trial using eye-tracking, continuous heart rate, difficulty rating scales, video observation and inte

Mills, Brennen W., Carter, Owen B.J., Rudd, Cobie J., Claxton, Louise A., Ross, Nathan P. and Strobel, Natalie A. 2016, Effects of low- versus high-fidelity simulations on the cognitive burden and performance of entry-level paramedicine students: a mixed-methods comparison trial using eye-tracking, continuous heart rate, difficulty rating scales, video observation and interviews, Simulation in healthcare, vol. 11, no. 1, pp. 10-18, doi: 10.1097/SIH.0000000000000119.

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Title Effects of low- versus high-fidelity simulations on the cognitive burden and performance of entry-level paramedicine students: a mixed-methods comparison trial using eye-tracking, continuous heart rate, difficulty rating scales, video observation and interviews
Author(s) Mills, Brennen W.
Carter, Owen B.J.
Rudd, Cobie J.
Claxton, Louise A.
Ross, Nathan P.
Strobel, Natalie A.
Journal name Simulation in healthcare
Volume number 11
Issue number 1
Start page 10
End page 18
Total pages 9
Publisher Lippincott William & Wilkins
Place of publication Philadephia, Pa.
Publication date 2016-02
ISSN 1559-713X
Keyword(s) early-stage students
paramedicine
simultation fidelity
eye tracking
performance
cognitive burden
Summary INTRODUCTION: High-fidelity simulation-based training is often avoided for early-stage students because of the assumption that while practicing newly learned skills, they are ill suited to processing multiple demands, which can lead to "cognitive overload" and poorer learning outcomes. We tested this assumption using a mixed-methods experimental design manipulating psychological immersion. METHODS: Thirty-nine randomly assigned first-year paramedicine students completed low- or high-environmental fidelity simulations [low-environmental fidelity simulations (LFenS) vs. high-environmental fidelity simulation (HFenS)] involving a manikin with obstructed airway (SimMan3G). Psychological immersion and cognitive burden were determined via continuous heart rate, eye tracking, self-report questionnaire (National Aeronautics and Space Administration Task Load Index), independent observation, and postsimulation interviews. Performance was assessed by successful location of obstruction and time-to-termination. RESULTS: Eye tracking confirmed that students attended to multiple, concurrent stimuli in HFenS and interviews consistently suggested that they experienced greater psychological immersion and cognitive burden than their LFenS counterparts. This was confirmed by significantly higher mean heart rate (P < 0.001) and National Aeronautics and Space Administration Task Load Index mental demand (P < 0.05). Although group allocation did not influence the proportion of students who ultimately revived the patient (58% vs. 30%, P < 0.10), the HFenS students did so significantly more quickly (P < 0.01). The LFenS students had low immersion resulting in greater assessment anxiety. CONCLUSIONS: High-environmental fidelity simulation engendered immersion and a sense of urgency in students, whereas LFenS created assessment anxiety and slower performance. We conclude that once early-stage students have learned the basics of a clinical skill, throwing them in the "deep end" of high-fidelity simulation creates significant additional cognitive burden but this has considerable educational merit.
Language eng
DOI 10.1097/SIH.0000000000000119
Field of Research 130209 Medicine, Nursing and Health Curriculum and Pedagogy
130202 Curriculum and Pedagogy Theory and Development
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, Society for Simulation in Healthcare
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080864

Document type: Journal Article
Collection: School of Medicine
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Created: Wed, 20 Jan 2016, 08:58:03 EST

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