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The evolution of cognitive load theory and its application to medical education
Open accessAbstract
Cognitive Load Theory (CLT) has started to find more applications in medical education research. Unfortunately, misconceptions such as lower cognitive load always being beneficial to learning and the continued use of dated concepts and methods can result in improper applications of CLT principles in medical education design and research. This review outlines how CLT has evolved and presents a synthesis of current-day CLT principles in a holistic model for medical education design. This model distinguishes three dimensions: task fidelity: from literature (lowest) through simulated patients to real patients (highest); task complexity: the number of information elements; and instructional support: from worked examples (highest) through completion tasks to autonomous task performance (lowest). These three dimensions together constitute three steps to proficient learning: (I) start with high support on low-fidelity low-complexity tasks and gradually fade that support as learners become more proficient; (II) repeat I for low-fidelity but higher-complexity tasks; and (III) repeat I and II in that order at subsequent levels of fidelity. The numbers of fidelity levels and complexity levels within fidelity levels needed depend on the aims of the course, curriculum or individual learning trajectory. This paper concludes with suggestions for future research based on this model.
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“An assessment after the out-of-class instruction is an excellent way to evaluate student comprehension of a topic and facilitate the use of mastery learning techniques (22).”
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Metadata
- Authors
- Leppink, J., & Van den Heuvel, A.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Leppink, Jimmie
- ORCID
- Leppink, Jimmie
- Venue
- Perspectives on Medical Education
- Publisher
- Ubiquity Press, Ltd.
- Published
- 2015-05-28
- Volume
- 4
- Issue
- 3
- Pages
- 119-127
- ISSN
- 2212-2761 (ISSN-L)
- 2212-277X
- PMC
- PMC4456454
- OpenAlex
- W1499793228
- Cited by
- 299
- References
- 62
- Citations by year
- 2026: 40 · 2025: 28 · 2024: 20 · 2023: 29 · 2022: 35 · 2021: 35 · 2020: 31 · 2019: 28 · 2018: 21 · 2017: 13 · 2016: 17 · 2015: 2
- FWCI
- 18.95
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Perspectives on Medical Education (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Visual and Cognitive Learning Processes
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- cognitive load theory, medical education, instructional design, task complexity, pedagogical support, worked examples, standardized patients
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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