Examining the experience of performance anxiety and cognitive load by medical residents in a simulation

Medical education increasingly incorporates simulations as a method of instruction, but further research about simulation development, use, and efficacy remains necessary. This study, which took place in a teaching hospital, surveyed medical residents on an Internal Medicine rotation about the experience of performance anxiety and cognitive load during a simulation exercise. Statistical significance was discovered in the means of self-reported performance anxiety pre- to post-simulation, and the factor of cognitive load was found to have a moderate correlation with post-simulation performance anxiety, though caution should be exercised considering the statistics owing to small sample size. A physician-faculty member and a resident nurse reported observations about the simulation exercises and the residents, highlighting questions of standardization of simulation use, the role of simulations as a curriculum component in medical education, and the importance of communication during simulation. Future areas of research are recommended for factors such as refinement of cognitive load measures, multiple cognitive load measure types, and the presence of additional factors in simulation experience such as demographic variation. Suggestions for practice include customization of simulations for specific learning environments, populations, and goals, as well as increasing emphasis on simulation for training in both medical content knowledge and social and psychological interaction.