• Natan Cramer, Noel Spears Zuckerbraun, Justin Puller, Andre D Furtado, Arjamon Deb, Michele L Dorfsman, Nalyn Siripong, Meghan Christie, and Melissa M Tavarez.
• From the Department of Emergency Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh.
• Pediatr Emerg Care. 2022 Feb 1; 38 (2): e771e775e771-e775.

ObjectiveWe built 2 versions of an asynchronous pediatric orthopedic educational intervention for emergency medicine residents and sought to compare the two. We hypothesized that the version incorporating more instructional scaffolding in the form of a cognitive aid (CA) would optimize germane cognitive load for our target novice learners and result in higher test scores.MethodsLearners were block randomized to either a "CA" or "non-CA" arm, each containing a random set of 18 modules. The CA arm incorporated an orthopedic fracture classification chart embedded within the diagnostic questions to guide the learner in forming a diagnosis. The non-CA arm was designed with more active learning as the classification chart was provided only after each diagnostic answer submission. For both arms, the final 6 modules completed per learner were scored. Learners also completed a perceived cognitive load assessment tool measured on a 10-point Likert scale.ResultsLearners in the non-CA arm had a mean total score on the testing modules of 33% correct compared with a mean total score of 44% correct for learners in the CA arm (mean difference, 11; 95% confidence interval, 4%-19%, P = 0.005). There was a trend for the CA arm to have lower perceived overall cognitive load scores; however, this did not reach statistical significance.ConclusionsEmergency medicine residents performed better after completing the CA version of our educational intervention. Applying cognitive load theory to an educational intervention may increase its success among target learners.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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