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The Cognitive Load of Inpatient Consults: Development of the Consult Cognitive Load Instrument and Initial Validity Evidence.
Brondfield, Sam; Blum, Alexander Mario; Lee, Kewchang; Linn, Marcia C; O'Sullivan, Patricia S.
Afiliação
  • Brondfield S; S. Brondfield is assistant professor, Department of Medicine, University of California, San Francisco, San Francisco, California.
  • Blum AM; A.M. Blum is lecturer, Department of Special Education, San Francisco State University, San Francisco, California.
  • Lee K; K. Lee is professor, Department of Psychiatry, University of California, San Francisco, San Francisco, California.
  • Linn MC; M.C. Linn is professor, Graduate School of Education, University of California, Berkeley, Berkeley, California.
  • O'Sullivan PS; P.S. O'Sullivan is professor, Departments of Medicine and Surgery, University of California, San Francisco, San Francisco, California.
Acad Med ; 96(12): 1732-1741, 2021 12 01.
Article em En | MEDLINE | ID: mdl-34039851
ABSTRACT

PURPOSE:

Fellows and residents provide inpatient consultations. Though consults vary considerably, measuring the associated cognitive load (CL) is key to guiding faculty on how to optimize learning during consults. However, existing CL instruments, such as the unidimensional Paas scale, cannot separate the 3 components of CL and may miss the nuances of consult CL. Therefore, the authors developed the Consult Cognitive Load (CCL) instrument to measure the 3 CL components during consults.

METHOD:

In 2018-2019, the authors developed the CCL at the University of California, San Francisco, using Wilson's constructive approach to measurement. To generate content and response process validity evidence, the authors consulted the literature and experts to generate construct maps, items, and a scoring rubric and conducted cognitive interviews. They administered the CCL to internal medicine and psychiatry trainees across 5 University of California campuses and used Rasch family and linear regression models to assess internal structure validity and relationships to key predictor variables. They compared the CCL with the Paas scale using Wright maps and used latent correlations to support separating CL into 3 components.

RESULTS:

Analysis revealed appropriate fit statistics, appropriate mean respondent location increases across all levels, threshold banding, and expected relationships with key predictor variables. The CCL provided more coverage of the 3 CL components compared with the Paas scale. Correlations among the 3 CL components were not strong, suggesting that the CCL offers more nuance than a unidimensional measure of CL in the context of consults.

CONCLUSIONS:

This study generated initial validity evidence to support the CCL's use as a measure of consult CL and supports measuring the 3 CL components separately rather than as a single construct in the context of consults. Learners and faculty could compare learner CCL scores with reference scores to promote reflection, metacognition, and coaching.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Testes de Estado Mental e Demência / Pacientes Internados Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Revista: Acad Med Assunto da revista: EDUCACAO Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encaminhamento e Consulta / Testes de Estado Mental e Demência / Pacientes Internados Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Humans Idioma: En Revista: Acad Med Assunto da revista: EDUCACAO Ano de publicação: 2021 Tipo de documento: Article