Different effects of pausing on cognitive load in a medical simulation game

In medical training, allowing learners to take pauses during tasks is known to enhance performance. Cognitive load theory assumes that insertion of pauses positively affects cognitive load, thereby enhancing performance. However, empirical studies on how allowing and taking pauses affects cognitive...

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Bibliographic Details
Published in:Computers in human behavior 2020-09, Vol.110, p.106385, Article 106385
Main Authors: Lee, Joy Yeonjoo, Donkers, Jeroen, Jarodzka, Halszka, Sellenraad, Géraldine, van Merriënboer, Jeroen J.G.
Format: Article
Language:English
Subjects:
Cognitive load
Computer simulation
Emergency medical services
Eye movements
Eye tracking
Games
Medical education
Medical simulation
Pause effect
Performance enhancement
Serious game
Simulation
Students
Telematics
Testing
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Summary:In medical training, allowing learners to take pauses during tasks is known to enhance performance. Cognitive load theory assumes that insertion of pauses positively affects cognitive load, thereby enhancing performance. However, empirical studies on how allowing and taking pauses affects cognitive load and performance in dynamic task environments are scarce. We investigated the pause effect, using a computerized simulation game in emergency medicine. Medical students (N = 70) were randomly assigned to one of two conditions: simulation with (n = 40) and without (n = 30) the option to take pauses. All participants played the same two scenarios, during which game logs and eye-tracking data were recorded. Overall, both cognitive load and performance were higher in the condition with pauses than in the one without. The act of pausing, however, temporarily lowered cognitive load, especially during intense moments. Two different manifestations of the pause effect were identified: (1) by stimulating additional cognitive and meta-cognitive processes, pauses increased overall cognitive load; and (2) through relaxation, the act of pausing temporarily decreased heightened cognitive load. Consequently, our results suggest that in order to enhance students’ performance and learning it is important that we encourage them to utilize the different effects of pausing. •The nature of pausing in nonlinear tasks is different from that in linear tasks.•Allowing pauses increases overall cognitive load, probably due to self-regulation.•Without instructions, taking actual pauses does not affect overall cognitive load.•In intense situations, cognitive load during pauses decreases temporarily.•Cognitive load during pauses differs by activities, e.g., reflection-relaxation.
ISSN:0747-5632
1873-7692
DOI:10.1016/j.chb.2020.106385