ArticlePloS one2025
Experienced cognitive load in the emergency department. A prospective study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Assessment and Factors Associated With Cognitive Load in Orthopaedic Nurses During Bedside Handover: A Cross-Sectional Study.Nursing open · 2026Article
- Artificial intelligence as cognitive support in emergency medicine.Clinical and experimental emergency medicine · 2026Article
- Deriving a Simple Clinical Predictive Score for Posterior Circulation Ischemic Stroke (PCS-SCORE).Journal of central nervous system disease · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and importanceThe emergency department (ED) is a hectic place, where many critically ill patients are treated. For residents working in the ED, this environment may be demanding.
objectivesThe aim of this study was to investigate the [1] cognitive load experienced by residents working in the ED, and [2] differences in cognitive load during the day.
methodsIn this multicentre, prospective study in three EDs in the Netherlands, the experienced cognitive load was graded by residents on three scales, agreed upon during Delphi meetings: the complexity (low-high: 1-3), mental effort (low-high: 1-9) and comfortability scale (low-high: 0-100%). We applied the scores per decision, 1-hour and 2-hour intervals, patient and shift. MAIN
resultsWe observed 14 residents and analysed 74 1-hour and 45 2-hour intervals, 79 patients, 24 shifts and 592 separate decisions. The experienced cognitive load per decision was low. In contrast, the cognitive load was higher per 2-hour interval (mental effort: median 4.0 (IQR 4.0) and comfortability 80% (IQR 20)) and per shift (mental effort: median 5.5 (IQR 4.0) and comfortability 80% (IQR 20). Complexity was low for all measurements. Mental effort rose from 17h onwards higher values, whereas a decrease in comfortability was seen from 21h onwards.
conclusionFrom 17h onwards, residents working in the ED experienced rather high mental effort and reported feeling not optimally comfortable when making decisions. The mental effort was highest between 21-23h. This was found when cognitive load was measured per 2-hour interval and per shift, but not per decision. This study may provide an insights to optimise cognitive load by reorganisation of the ED.
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