Cognitive load in internal medicine: What every clinical teacher should know about cognitive load theory

Eur J Intern Med. 2019 Feb:60:4-8. doi: 10.1016/j.ejim.2018.08.013. Epub 2018 Sep 1.


Internal medicine is an appropriate example of specialties in which to teach learners clinical reasoning skills, decision-making, and analytical thinking, as well as evidence-based, patient-oriented medicine. During daily clinical work, general internists always encounter a multitude of situations that lend themselves to educating medical trainees in ambulatory and inpatient settings. Application of existing learning theories to teaching has been shown to optimize teaching ability and to maximize the efficiency of teaching efforts. Cognitive Load Theory explains learning according to three important aspects: the types of memory (working and long-term memory), the learning process and the forms of cognitive load that affect our learning. The aim of this paper is to show the main perspectives and implications of the Cognitive Load Theory on clinical educational practices. It is important to give the right amount of information in the most effective way to learners, thereby making this information more useful. This article presents a concise overview of the basis of the Cognitive Load Theory in its first part, and, in its second part, it exposes the practical applications of this theory with examples. This learning theory will encourage clinical teachers to reflect on how to foster learning in medical trainees in the more effective way.

Keywords: Academic Internal Medicine; Bedside teaching; Clinical teaching; Cognitive Load Theory; Medical Education; Medical Teacher.

Publication types

  • Review

MeSH terms

  • Clinical Competence
  • Education, Medical / methods*
  • Faculty, Medical*
  • Humans
  • Internal Medicine / education*
  • Memory / physiology*
  • Models, Educational