Mental workload as a key factor in clinical decision making
Abstract
The decision making process is central to the practice of a clinician and has traditionally been described in terms of the hypothetico-deductive model. More recently, models adapted from cognitive psychology, such as the dual process and script theories have proved useful in explaining patterns of practice not consistent with purely cognitive based practice. The purpose of this paper is to introduce the concept of mental workload as a key determinant of the type of cognitive processing used by clinicians. Published research appears to be consistent with 'schemata' based cognition as the principle mode of working for those engaged in complex tasks under time pressure. Although conscious processing of factual data is also used, it may be the primary mode of cognition only in situations where time pressure is not a factor. Further research on the decision making process should be based on outcomes which are not dependant on conscious recall of past actions or events and include a measure of mental workload. This further appears to support the concept of the patient, within the clinical environment, as the most effective learning resource.
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Experienced clinicians relied on metacognitive skills to identify relevant details and adapt basic science knowledge into appropriate clinical decisions, whereas novices relied more heavily on predetermined treatment routines.
“For example, when presented with complex clinical scenarios, experienced clinicians consistently relied on their metacognitive skills to identify relevant details and adapt their basic science knowledge into an appropriate clinical decision, whereas novices relied more heavily on predetermined treatment routines (Byrne, 2013).”
From Promoting metacognition in an allied health anatomy course (2023) · cites this paper as Byrne, 2013
Increased educational stress and cognitive workload can negatively impact metacognition.
“Given that increased educational stress and cognitive workload can negatively impact metacognition (Byrne, 2013; Saricam et al.,2017)”
From Promoting metacognition in an allied health anatomy course (2023) · cites this paper as Byrne, 2013
Mental workload is a multidimensional concept reflecting work behaviour, effort and performance in complex and dynamic situations.
“mental workload is a multidimensional concept reflecting work behaviour, effort and performance in complex and dynamic situations [17]”
From Workflow interruption and nurses’ mental workload in electronic health record tasks: An observational study (2023) · cites this paper as [17]
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“…complex clinical scenarios, experienced clinicians consistently relied on their metacognitive skills to identify relevant details and adapt their basic science knowledge into an appropriate clinical decision, whereas novices relied more heavily on predetermined treatment routines (Byrne, 2013).”
Background
- Authors
- Byrne, A.
- Affiliations
- Cardiff University (GB)
- Corresponding author
- Byrne, Aidan
- ORCID
- Byrne, Aidan
- Venue
- Advances in Health Sciences Education
- Published
- 2012-03-13
- Volume
- 18
- Issue
- 3
- Pages
- 537-545
- ISSN
- 1382-4996 (ISSN-L)
- 1573-1677
- OpenAlex
- W2074050068
- Cited by
- 47
- References
- 52
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Advances in Health Sciences Education (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- mental workload, clinical decision-making, dual-process theory, script theory, schema theory, cognitive processes, time pressure, conscious processing, hypothetico-deductive method
- MeSH terms
- Clinical Competence, Cognition, Decision Making, Education, Medical, Humans, Physicians
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