International Journal for Quality in Health Care Advance Access originally published online on March 8, 2007
International Journal for Quality in Health Care 2007 19(3):127-133; doi:10.1093/intqhc/mzm007
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
An exploratory study of cognitive load in diagnosing patient conditions
1 College of Business, Florida Institute of Technology, 150 West University Blvd, Melbourne, FL 32901, USA
2 LMI of Brevard, Inc. Holmes Regional Medical Center, 1350 S Hickory Street, Melbourne, FL 32901, USA
3 College of Information, Florida State University, 101 Louis Shores Building, Tallahassee, FL 32306, USA
Objective. To determine whether the ways in which information is presented to physicians will improve their ability to respond in a timely and accurate manner to acute care needs. The forms of the presentation compared traditional textual, chart and graph representations with equivalent symbolic language representations. To test this objective, our investigation involved two studies of interpreting patient conditions using two forms of information representation. The first assessed the level of cognitive effort (the outcome variable is known as cognitive load), and the second assessed the time and accuracy outcome variables.
Participants. Our investigation consisted of two studies, the first study involved 3rd and 4th year medical students, and the second study involved three board certified physicians who worked in an intensive care unit of a metropolitan hospital.
Design. The first study utilized an all-within-subject design with repeated measures, where pretests were utilized as control covariate for prior learning and individual differences. The second study utilized a random sampling of records analyzed by two physicians and qualitatively evaluated by board-certified intensivists.
Results. The first study indicated that the cognitive load to interpret the symbolic representation was less than those presented in the more traditional textual, chart and graphic form. The second study suggests that experienced physicians may react in a more timely fashion with at least the same accuracy when the symbolic language was used than with traditional charts and graphs.
Conclusions. The ways in which information is presented to physicians may affect the quality of acute care, such as in intensive, critical and emergency care units. When information can be presented in symbolic form, it may be cognitively processed more efficiently than when it is presented in the usual textual and chart form, potentially lowering errors in diagnosis and increasing the responsiveness to patient conditions.
Keywords: acute care, cognitive load, visual information representation
Address reprint requests to: Michael Workman, College of Business, Florida Institute of Technology, 150 West University Blvd, Melbourne, FL 32901, USA. E-mail: workmanfit{at}yahoo.com/ workmanfsu{at}yahoo.com
Accepted for publication February 3, 2007.