Using AI to Synthesize Knowledge in #MedEd: A Pipeline

It turns out that using AI for #MedEd could be done by most clinician-educators at a nominal cost. Below, we present a pipeline for using #AI to quickly synthesize medical education theory into content! We’d say it’s easy as 1,2,3 …except there’s a fourth step.

Find articles that apply or describe your theory of interest effectively in medical education, then combine them. This is likely to be aided by a subject matter expert or someone who has deep knowledge of the theory and its applications. This is an extremely important step, because as we explore in our Use of Theory MEM, historically theory has been used with various effectiveness in medical education.

Worked example: Cognitive Load Theory

We used the 5 key citations identified by our subject matter expert in Cognitive Load Theory, and we used a PDF combiner to put them all together. This took about 30 seconds, although the hard part (i.e., finding the best references) had been done by someone else.

• Sewell et al 2019. "Cognitive load theory for training health professionals in the workplace: A BEME review of studies among diverse professions: BEME Guide No. 53." Medical Teacher. 41(3):256-70.

• Young et al 2014. "Cognitive load theory: implications for medical education: AMEE Guide No. 86." Medical Teacher. 36(5):371-84.


• Kalyuga et al 2003. "The expertise reversal effect." Educational Psychologist. 38:1, 23-31.


• van Merriënboer & Sweller 2010. "Cognitive load theory in health professional education: design principles and strategies." Medical Education. 44(1):85-93.


• Szulewski et al 2020. "From theory to practice: the application of cognitive load theory to the practice of medicine." Acad Med. Published ahead of print.

Here’s the output (largely unedited in this case for demonstration!):

Summary of Cognitive Load Theory

Cognitive Load Theory (CLT) has evolved to become a leading model in educational psychology, gaining traction in the medical education community over the last decade. Rooted in the understanding of human cognitive architecture, it delineates how an individual's limited working memory interacts with an unlimited long-term memory during the learning process.

Initially, it was primarily a theory of learning but has now found parallels in broader aspects of medical education and clinical practice, especially in complex environments like resuscitation medicine. The theory has been re-contextualized to apply to complex professional domains, making the connections between theory and clinical practice explicit, with resuscitation medicine serving as a case study. The theory is grounded in the interaction between an individual's limited working memory and unlimited long-term memory during learning processes, emphasizing the role of cognitive schemas stored in the long-term memory developed through learning.

Key Concepts

• Intrinsic Load: Directly related to the complexity of the task at hand and the learner's expertise.

• Extraneous Load: Results from unnecessary processes that do not contribute to learning.

• Germane Load: Engages with intrinsic cognitive load, facilitating the construction and automation of mental schemas that relate information elements to each other.

• Working Memory Depletion: A new construct in CLT, it considers the effects of working memory being exhausted over time.

• Affect: Another recent addition to CLT, it considers factors like emotion, stress, and uncertainty in influencing cognitive load.

• Cognitive Overload: Occurs when the sum of intrinsic and extraneous loads exceeds the working memory capacity, leading to poorer learning outcomes.

The main principle for educators is to minimize extraneous cognitive load to optimize germane cognitive load within the available cognitive capacity limits.

Examples of Cognitive Load Theory in Med Ed

• In medical education, CLT has been utilized to optimize instructional design, drawing parallels in medical assessment and simulation, as well as professional practice. It has been expanded to include constructs like working memory depletion and affect, considering factors like emotion, stress, and uncertainty that can influence cognitive load.

• The theory is now being applied in complex fields like resuscitation medicine, bridging gaps between theory and practice and fostering discussions on new advances in CLT. The theory is also beginning to find applications in medical education, emphasizing the use of authentic tasks to help students integrate knowledge, skills, and attitudes necessary for effective task performance in their educational programs.

Worked Example: Applying CLT in Renal Physiology Class

Scenario: Medical students are learning how to calculate the anion-gap in a renal physiology class.

Step 1: Introduction to the Concept (Managing Intrinsic Load)

• Instructor: Introduces the concept of anion-gap and why it is essential in renal physiology.

• Learning Materials: Students are provided with a handout that briefly explains the concept with a simple diagram illustrating the anion-gap.

Step 2: Demonstration (Worked Example) (Reducing Extraneous Load)

• Instructor: Provides a worked example demonstrating how to calculate the anion-gap step by step, explaining each step clearly and concisely to avoid overloading the students with too much information at once.

• Learning Materials: A step-by-step guide with integrated text and images is displayed on a screen to reduce split-attention effect.

Step 3: Guided Practice (Problem Completion) (Optimizing Germane Load)

• Instructor: Gives the students a worksheet with partially completed problems and asks them to complete the missing steps in calculating the anion-gap, offering guidance and feedback as necessary.

• Learning Materials: Students have access to a worksheet with partially completed problems to help them focus on understanding and mastering the specific steps involved in calculating the anion-gap.

Step 4: Feedback and Reflection (Facilitating Schema Construction)

• Instructor: Reviews the solutions to the problems with the class, encouraging students to reflect on their performance and understand the solution path clearly.

• Learning Materials: Students are encouraged to note down any tips or tricks shared during the feedback session for future reference.

Step 5: Independent Practice (Encouraging Schema Automation)

• Instructor: Assigns homework problems where students have to calculate the anion-gap from scratch, encouraging them to apply the knowledge and skills they have acquired during the class independently.

• Learning Materials: Students are provided with a set of problems to solve as homework, encouraging them to apply the schemas they have built during the class to solve problems independently.

Outcome:

• By the end of the session, students have not only understood the concept of anion-gap but have also practiced calculating it through guided and independent problem-solving activities, fostering the construction and automation of schemas in their long-term memory.

• In this worked example, the medical educator applies the principles of CLT to design a class session that carefully manages the different types of cognitive load to facilitate effective learning. The educator uses a variety of strategies to reduce extraneous load, manage intrinsic load, and optimize germane load, promoting the construction and automation of schemas in the learners' long-term memory.