Speech-accompanying gestures have been shown to reduce cognitive load on a secondary task compared to speaking without gestures. In the current study, we investigate whether this benefit of speech-accompanying gestures is shared by speech-accompanying actions (i.e., movements that leave a lasting trace in the physical world). In two experiments, participants attempted to retain verbal and spatial information from a grid while describing a pattern while gesturing, while making the pattern, or while keeping hands still. Producing gestures reduced verbal load compared to keeping hands still when the pattern being described was visually present (Experiment 1), and this benefit was not shared by making the pattern. However, when the pattern being described was not visually present (Experiment 2), making the pattern benefited verbal load compared to keeping hands still. Neither experiment revealed a significant difference between gesture and action. Taken together, the findings suggest that moving the hands in meaningful ways can benefit verbal load.

Designers are experiencing greater mental demands given the complexity of design tools, necessitating the study of cognitive load in design. Researchers have identified task- and designer-related factors that affect cognitive load; however, these studies primarily use self-reported measures that could be inaccurate and incomplete. Little research has tested the accuracy and completeness of self-reported measures and we aim to explore this gap. Towards this aim, we seek to answer the question: How does cognitive load vary based on the different design representations used, and do these differences depend on the measure of cognitive load? From our results, we see that the design representations vary in the range of cognitive load experienced by designers when using them. Moreover, this role of the range of cognitive load variance was observed given our use of pupil diameter. These findings call for the use of a multi-modal approach for measuring cognitive load with the combined use of subjective (e.g., self-report) and objective measures (e.g., physiological measures), as well as the use of both retrospective (e.g., self-report) and concurrent measures (e.g., physiological measures).

As an initial step towards a better understanding of cognitive load in computer-aided design (CAD), the herein presented study investigated cognitive load imposed on 24 mechanical engineers during two CAD modelling tasks of intentionally different complexity levels. The cognitive load has been rarely studied in the CAD context, which resulted in the lack of understanding if and how the EEG-based indicators available from the literature reflect the changes in cognitive load imposed on engineering designers in CAD activities. Therefore, cognitive load was measured and analysed using three EEG-based indicators to explore insights that might be obtained from them. The initial analysis revealed different cognitive load results from the employed indicators for the same EEG data. In addition, the study implies that the cognitive load results obtained through the used indicators are only partially coherent with the CAD modelling task complexity. Hence, the results imply that the chosen EEG-based indicator matters when measuring and analysing cognitive load in CAD modelling tasks and that its adjustment for CAD context might be needed.

The prominent dual process model of moral cognition suggests that reasoners intuitively detect that harming others is wrong (deontological System-1 morality) but have to engage in demanding deliberation to realize that harm can be acceptable depending on the consequences (utilitarian System-2 morality). But the nature of the interaction between the processes is not clear. To address this key issue we tested whether deontological reasoners also intuitively grasp the utilitarian dimensions of classic moral dilemmas. In three studies subjects solved moral dilemmas in which utilitarian and deontological considerations cued conflicting or non-conflicting decisions while performing a demanding concurrent load task. Results show that reasoners’ sensitivity to conflicting moral perspectives, as reflected in decreased decision confidence and increased experienced processing difficulty, was unaffected by cognitive load. We discuss how these findings argue for a hybrid dual process model interpretation in which System-1 cues both a deontological and utilitarian intuition.

The objective evaluation of empirical studies is an important part when assessing demand and validating design methods. However, metrics that can also map cognitive processes during design are still lacking. In order to address this problem, an online study with 12 participants was conducted. The aim of this investigation was to find a relation between cognitive load and performance in engineering design tasks. To assess the cognitive load, the NASA-RTLX questionnaire was used as an established measurement tool and was related to the results achieved by the participants. The results show that there is a correlation between the two investigated parameters. Based on a statistical analysis a correlation between increasing cognitive load and a decrease in performance could be identified. The tasks used produce comparable results to other studies investigating cognitive load, but the task causing the highest cognitive load shows the widest scatter in performance. The u-curve as suggested by the state of the art was not visible in the study’s results, but the cognitive load should be nevertheless used for studies of design processes, because it may reveal a need for methodical support.

Introduction: As physicians gain expertise in clinical settings, they are able to handle progressively more information, in both complexity and magnitude, as an organized schema. Expert physicians then, will be more likely to function with less cognitive load —the amount of mental effort someone exerts within their short-term working memory. Expert physicians will also retain more working memory capacity to process information during medical emergencies than novice physicians. While a physician's ability to process medical information may have implications for handling medical emergencies, there is a paucity of empirical research examining the link between physicians’ expertise and biometric measures of cognitive load. Using galvanic skin response (GSR) as a surrogate measure of cognitive load, we assess whether average cognitive load differs significantly between expert and novice physicians in a pulmonary embolism simulation exercise. Methods: We analyzed GSR data (n = 39) from a 10-minute simulated pulmonary embolism exercise among 18 faculty physicians and 21 residents. Cluster and factor analyses were used to identify novice, intermediate, advanced, and expert physicians with based on participants’ GRS scores. One-way ANOVA was used to analyze group differences. Descriptive statistical techniques were also used to describe the distribution of GRS expertise by participants’ level of training. Results: Contrary to expectation, we found more than two groups of resuscitation expertise in the simulation exercise. Respectively, we identified 7.7% and 20.5% of participants as novice and expert physicians. About 36% of participants were classified as intermediate (35.9%) physicians while another 36% were classified as having an advanced (35.9%) expertise in resuscitation. All the novice physicians identified were found to be PGY1 and PGY2 resident residents. A third (33.3%) of faculty physicians and 9.5% of residents were identified as experts. As expected, average GSR score for experts (x¯ = 0.60μS, SD = 0.26) was significantly (F = 137.6, p < 0.001) lower than the average GSR for novices (x¯ = 5.55μS, SD = 0.99), intermediate (x¯ = 2.84 μS, SD = 0.40), and advanced (x¯ = 1.57 μS, SD = 0.28) physicians. Conclusion: GSR measures of cognitive load may be used to identify resuscitation expertise in managing pulmonary embolism and related medical conditions through simulation exercises.

Introduction: Clinical simulations in are designed to evoke feelings of stress and uncertainty in order to mimic challenges that learners will face in the real world. When not managed properly, these sources of extraneous cognitive load cause a burden on working memory, leading to a hindered ability to acquire new information. The “Beat the Stress Fool” (BTSF) protocol is a performance-enhancing tool designed to reduce cognitive overload during acute care scenarios. It involves breathing exercises, positive self-talk, visualization, and deliberate articulations. This study aims to validate the BTSF protocol as a method for reducing cognitive load using both psychometric and physiologic measures. Methods: Data collection took place during the Queen's University “Nightmares-FM” course. This clinical simulation program involves team-based scenarios designed to teach the fundamentals of acute care to first-year family medicine residents. Participants were divided equally into experimental and control groups based on pre-existing cohorts. Participants completed a baseline state-trait anxiety inventory and a demographics survey. The experimental group was guided through the BTSF protocol prior to each of 16 simulations; in both groups, physiologic and psychometric cognitive load measurements were collected for the alternating team leader. Galvanic skin response (GSR) and heart rate (HR) were collected during a 15-second baseline and throughout each simulation using a Shimmer 3 GSR+ wearable sensor. Self-reported cognitive load was assessed after each scenario using the 9-point Paas scale. Results: The mean Paas scores for the BTSF group were significantly lower than the control group (6.2 vs 6.9, p < 0.05), indicating lower subjective cognitive load. GSR signal magnitude (p = 0.086), spike amplitude (p = 0.066), and spike density (p = 0.584) were also lower in the BTSF group. There was no difference in HR between groups. There was not a significant correlation between self-reported cognitive load and the normalized physiologic measures. Conclusion: The results demonstrate the effectiveness of the BTSF protocol in lowering the amount of perceived mental effort required to perform clinical simulation tasks. These findings were mirrored in the galvanic skin response signal, though our study was likely underpowered for significance. This is the first study to validate a proof-of-concept for the BTSF protocol in learners during simulated training.

Failing to communicate a message in everyday settings can be a frustrating experience. However, miscommunication can lead to disaster in high-stakes situations. Yet in these contexts, under pressure to perform efficiently, speakers may also find themselves with limited resources to devote to message clarity. To understand how cognitive constraint affects communication and explore a possible low-cost solution, we investigated a method for moderating ambiguity production in the face of competing attentional demands: taking the perspective of the listener. Over two experiments, speakers labeled images (Experiment 1) or provided instructions (Experiment 2) to listeners in a non-interactive communication task. In both experiments, speakers were randomly assigned to cognitive constraint and perspective-taking conditions, such that some speakers were under higher cognitive constraint and some speakers received a simple perspective-taking directive. We replicated previous findings that additional cognitive constraint impairs speakers’ ability to avoid ambiguity. Additionally, we found that a simple directive can promote speaker clarity when labeling images, but not when providing instructions. These results suggest that a simple directive is likely insufficient to ensure speaker clarity in all cases.

Introduction: By virtue of the nature of their work, emergency medicine physicians and residents experience high cognitive load and stress, which are known to affect physician performance and patient outcomes. However, the contribution of cognitive load has not previously been measured during the clinical work of emergency physicians. The objectives of this study were to measure cognitive load and stress in emergency physicians and residents during clinical work, evaluate the relative contribution of multiple factors on cognitive load, and to determine the effect of experience on these results. Methods: This observational study was conducted at an academic Canadian Urgent Care Centre from July to August 2018. Emergency medicine residents and staff physicians completed a survey while on shift to evaluate measures of cognitive load and acute stress. Patient acuity and the number of active patients for each physician, hours worked and patients in the waiting room were recorded. Correlational analyses and multivariable linear regression were performed to evaluate the effect of each predictor on measures of overall cognitive load. Results: A total of 131 questionnaires were completed by 42 physicians (87 questionnaires from 26 staff physicians and 44 questionnaires from 16 residents). Results showed that staff physicians carried a significantly higher patient load compared to residents (p < 0.001). There were no differences in mean overall cognitive load (p = 0.25), acute stress (p = 0.17) or measured subcomponents of cognitive load between the two groups. Perceived case difficulty and acute stress were strong predictors of overall cognitive load, while level of distraction did not correlate with the other outcomes. The number of patients in the waiting room predicted acute stress in staff physicians, while the number of higher acuity patients was a significant predictor in residents. Conclusion: Measures of overall cognitive load and acute stress were strongly correlated in the clinical setting. Different factors affect cognitive load and acute stress in staff physicians compared to residents. Appreciating these differences may help medical educators understand the cognitive challenges faced by learners in a clinical context, and aid in the design of cognitive and educational strategies to help mitigate these challenges and reduce stress.

With declining vision ability, character spacing and size on smartphones designed for the general population are not accessible for older adults. This study aimed to explore how larger Chinese character spacing and size affect older adults’ user experience (UX). An orthogonal experiment was conducted. The optimal range of font size (FS), word spacing (WS) and line spacing (LS) were proposed utilising subjective evaluations to investigate the correlation of eye movement data with participants perceived UX. The results showed that improvement in different aspects of UX varied when FS, WS and LS increased. Overall, participants preferred larger FS, WS and LS, however, the larger FS, WS and LS values are more likely to cause errors and slower reading speed. These results suggest that the distinct combination of size and spacing depends on the motivation, needs and situation of older people when reading on a smartphone. These findings will help designers to provide better design for the older people.

Compared to traditional pen-and-paper presentation of information, computer-assisted argument mapping seems to be more efficient in developing lower order thinking skills such as memory and comprehension. The present study investigated the impact of argument map construction and reading via computer versus pen and paper on English as a foreign language (EFL) majors’ comprehension, recall, and retention of argumentative texts. To this end, 120 Iranian EFL undergraduates were divided into low and high proficiency levels after taking a language proficiency test. Next, they were randomly assigned to two experimental groups; each group received 12 sessions of argument mapping instruction, one via computer and the other via pen and paper. At the end of the term, participants randomly received two argument map sizes (small vs. large) and were given 15 minutes to read the maps. Then tests of recall and comprehension relevant to the maps were administered, followed by a test of retention within a two-week interval. The results revealed that after controlling for spatial and verbal covariates, the type of treatment had a significant effect on recall, retention, and comprehension, with the software group outperforming the pen-and-paper group; however, proficiency level and argument size did not show any significant effect.

Introduction: In the clinical settings, emergency physicians are faced with situations that require multitasking such as interacting with other team members, documentation and utilization of computer resources whiles ensuring competency on a particular trauma skill. The purpose of this study was to assess the effect of multitasking on cognitive load when learning a common trauma skill. Methods: Sixteen students who had no previous experience with the one-handed square knot were randomly assigned to one of the two groups: practice and non-practice groups. A pre-recorded instructional video of a one-hand knot tying was presented to all participants. Next, the practice group completed a single session of 10 trials of the one-hand knot tying using a benchtop simulator, while the non-practice group did not. All returned a week later for a transfer task on a different simulator. On trials 1, 4, 7,10 and during the transfer performance the participants performed under dual task conditions, where they were asked to focus on the knot-tying task, but also to react as fast as possible to the illumination of an incandescent light bulb by pressing a foot pedal. Subjective ratings of mental effort, and reaction time to the visual stimulus were used as indices of cognitive load. Results: A repeated measure ANOVA showed a significant effect of dual task on subjective measure of mental effort (F(4, 28) = 10.35, p = .001, ω = .60) and reaction time (F(4, 28) = 7.93, p = .001, ω = .53), with plots indicating cognitive load plateaued by the 7th trial. Conclusion: These findings highlights the number of trials necessary to attain a level of proficiency in a basic trauma skill such as the one-hand knot tying, ease the level of cognitive load and possibly enhance transfer to more challenging tasks.

Cognitive load theory has been utilized by second language acquisition (SLA) researchers to account for differences in learner performance with regards to different learning tasks. Certain instructional designs were shown to have an impact on cognitive load and working memory, and this impact was found to be accentuated in a multimedia environment where there is a variety of interacting elements and tools that can lead to cognitive overload and consequently reduced learning outcomes. This study investigated the influence of split-attention and integrated instructional formats on students’ cognitive load and how they might facilitate second language online reading and vocabulary learning. Twenty English as a Second Language (ESL) intermediate students studying at an Australian language institution were randomly assigned to four conditions: SAND (Split-Attention No Dictionary), SAOD (Split-Attention with Online Dictionary), IFND (Integrated Format No Dictionary), and IFOD (Integrated Format with Online Dictionary). Subjects were asked to complete an online reading comprehension task in which subjects tested under the SAND and SAOD conditions were exposed to a typical reading text followed by comprehension questions, whereas subjects in the IFND and IFOD conditions were exposed to a reading text where the comprehension questions were physically inserted within the reading text. Under the SAOD and IFOD conditions, subjects had access to an online dictionary. Results showed that the integrated reading format was found to facilitate students’ reading comprehension more than the split-attention format. Also, students who had access to the online dictionary in the SAOD and IFOD groups performed better on the vocabulary test, but spent more time on the reading task than the other two groups. Furthermore, participants in the split-attention format group looked up more words than their counterparts in the integrated format group. The results of the present study have certain implications for multimedia instructional designers and ESL teachers.

As many as 50% of multiple sclerosis (MS) patients experience clinical or subclinical depression. A voluminous literature has documented affective memory biases (AMB) among depressed individuals. Despite this, little is known regarding how depressive symptoms may affect MS patients' ability to recall positive and negative material. The present study employed an affective list-learning task that increased cognitive load and inhibited the use of higher order encoding strategies. The purpose of the study was twofold: to determine whether MS patients exhibit AMB and to examine whether subvocal repetition and other higher order encoding strategies are essential to the formation of AMB among people experiencing depression. Results indicated a strong relationship between depression and AMB in MS. The results are discussed in relation to existing biological research that indicates limbic and/or other subcortical systems may play a role in the formation of AMB. (JINS, 2005, 11, 514–521.)