An exploratory study of cognitive load in diagnosing patient conditions.

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.