Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load

Soroosh Solhjoo; Mark C. Haigney; Elexis McBee; Jeroen J. G. van Merrienboer; Lambert Schuwirth; Anthony R. Artino; Alexis Battista; Temple A. Ratcliffe; Howard D. Lee; Steven J. Durning

doi:10.1038/s41598-019-50280-3

Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load

Soroosh Solhjoo^*, Mark C. Haigney, Elexis McBee, Jeroen J. G. van Merrienboer, Lambert Schuwirth, Anthony R. Artino, Alexis Battista, Temple A. Ratcliffe, Howard D. Lee, Steven J. Durning

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Cognitive load is a key mediator of cognitive processing that may impact clinical reasoning performance. The purpose of this study was to gather biologic validity evidence for correlates of different types of self-reported cognitive load, and to explore the association of self-reported cognitive load and physiologic measures with clinical reasoning performance. We hypothesized that increased cognitive load would manifest evidence of elevated sympathetic tone and would be associated with lower clinical reasoning performance scores. Fifteen medical students wore Holter monitors and watched three videos depicting medical encounters before completing a post-encounter form and standard measures of cognitive load. Correlation analysis was used to investigate the relationship between cardiac measures (mean heart rate, heart rate variability and QT interval variability) and self-reported measures of cognitive load, and their association with clinical reasoning performance scores. Despite the low number of participants, strong positive correlations were found between measures of intrinsic cognitive load and heart rate variability. Performance was negatively correlated with mean heart rate, as well as single-item cognitive load measures. Our data signify a possible role for using physiologic monitoring for identifying individuals experiencing high cognitive load and those at risk for performing poorly during clinical reasoning tasks.

Original language	English
Article number	14668
Number of pages	9
Journal	Scientific Reports
Volume	9
DOIs	https://doi.org/10.1038/s41598-019-50280-3
Publication status	Published - 11 Oct 2019

Keywords

INSTRUCTIONAL-DESIGN
MENTAL STRESS
PERSPECTIVE
CONTEXT
ENVIRONMENT
EXAMPLES
EXPERTS
MODEL

Access to Document

10.1038/s41598-019-50280-3Licence: CC BY

Cite this

Solhjoo, S., Haigney, M. C., McBee, E., van Merrienboer, J. J. G., Schuwirth, L., Artino, A. R., Battista, A., Ratcliffe, T. A., Lee, H. D., & Durning, S. J. (2019). Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load. Scientific Reports, 9, Article 14668. https://doi.org/10.1038/s41598-019-50280-3

@article{77d8bc9fa42f4c34a9c6e2b5d9c1cec3,

title = "Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load",

abstract = "Cognitive load is a key mediator of cognitive processing that may impact clinical reasoning performance. The purpose of this study was to gather biologic validity evidence for correlates of different types of self-reported cognitive load, and to explore the association of self-reported cognitive load and physiologic measures with clinical reasoning performance. We hypothesized that increased cognitive load would manifest evidence of elevated sympathetic tone and would be associated with lower clinical reasoning performance scores. Fifteen medical students wore Holter monitors and watched three videos depicting medical encounters before completing a post-encounter form and standard measures of cognitive load. Correlation analysis was used to investigate the relationship between cardiac measures (mean heart rate, heart rate variability and QT interval variability) and self-reported measures of cognitive load, and their association with clinical reasoning performance scores. Despite the low number of participants, strong positive correlations were found between measures of intrinsic cognitive load and heart rate variability. Performance was negatively correlated with mean heart rate, as well as single-item cognitive load measures. Our data signify a possible role for using physiologic monitoring for identifying individuals experiencing high cognitive load and those at risk for performing poorly during clinical reasoning tasks.",

keywords = "INSTRUCTIONAL-DESIGN, MENTAL STRESS, PERSPECTIVE, CONTEXT, ENVIRONMENT, EXAMPLES, EXPERTS, MODEL",

author = "Soroosh Solhjoo and Haigney, {Mark C.} and Elexis McBee and {van Merrienboer}, {Jeroen J. G.} and Lambert Schuwirth and Artino, {Anthony R.} and Alexis Battista and Ratcliffe, {Temple A.} and Lee, {Howard D.} and Durning, {Steven J.}",

note = "Funding Information: This work was supported by JPC-1 Award # 65126 (to S.D.). S.S. was supported by 5T32HL007227 (NIH) and 14POST20000018 (AHA). The authors would like to thank Kathleen Wortmann and Katherine Picho for assistance with data acquisition and management. Publisher Copyright: {\textcopyright} 2019, The Author(s).",

year = "2019",

month = oct,

day = "11",

doi = "10.1038/s41598-019-50280-3",

language = "English",

volume = "9",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Heart Rate and Heart Rate Variability Correlate with Clinical Reasoning Performance and Self-Reported Measures of Cognitive Load

AU - Solhjoo, Soroosh

AU - Haigney, Mark C.

AU - McBee, Elexis

AU - van Merrienboer, Jeroen J. G.

AU - Schuwirth, Lambert

AU - Artino, Anthony R.

AU - Battista, Alexis

AU - Ratcliffe, Temple A.

AU - Lee, Howard D.

AU - Durning, Steven J.

N1 - Funding Information: This work was supported by JPC-1 Award # 65126 (to S.D.). S.S. was supported by 5T32HL007227 (NIH) and 14POST20000018 (AHA). The authors would like to thank Kathleen Wortmann and Katherine Picho for assistance with data acquisition and management. Publisher Copyright: © 2019, The Author(s).

PY - 2019/10/11

Y1 - 2019/10/11

N2 - Cognitive load is a key mediator of cognitive processing that may impact clinical reasoning performance. The purpose of this study was to gather biologic validity evidence for correlates of different types of self-reported cognitive load, and to explore the association of self-reported cognitive load and physiologic measures with clinical reasoning performance. We hypothesized that increased cognitive load would manifest evidence of elevated sympathetic tone and would be associated with lower clinical reasoning performance scores. Fifteen medical students wore Holter monitors and watched three videos depicting medical encounters before completing a post-encounter form and standard measures of cognitive load. Correlation analysis was used to investigate the relationship between cardiac measures (mean heart rate, heart rate variability and QT interval variability) and self-reported measures of cognitive load, and their association with clinical reasoning performance scores. Despite the low number of participants, strong positive correlations were found between measures of intrinsic cognitive load and heart rate variability. Performance was negatively correlated with mean heart rate, as well as single-item cognitive load measures. Our data signify a possible role for using physiologic monitoring for identifying individuals experiencing high cognitive load and those at risk for performing poorly during clinical reasoning tasks.

AB - Cognitive load is a key mediator of cognitive processing that may impact clinical reasoning performance. The purpose of this study was to gather biologic validity evidence for correlates of different types of self-reported cognitive load, and to explore the association of self-reported cognitive load and physiologic measures with clinical reasoning performance. We hypothesized that increased cognitive load would manifest evidence of elevated sympathetic tone and would be associated with lower clinical reasoning performance scores. Fifteen medical students wore Holter monitors and watched three videos depicting medical encounters before completing a post-encounter form and standard measures of cognitive load. Correlation analysis was used to investigate the relationship between cardiac measures (mean heart rate, heart rate variability and QT interval variability) and self-reported measures of cognitive load, and their association with clinical reasoning performance scores. Despite the low number of participants, strong positive correlations were found between measures of intrinsic cognitive load and heart rate variability. Performance was negatively correlated with mean heart rate, as well as single-item cognitive load measures. Our data signify a possible role for using physiologic monitoring for identifying individuals experiencing high cognitive load and those at risk for performing poorly during clinical reasoning tasks.

KW - INSTRUCTIONAL-DESIGN

KW - MENTAL STRESS

KW - PERSPECTIVE

KW - CONTEXT

KW - ENVIRONMENT

KW - EXAMPLES

KW - EXPERTS

KW - MODEL

U2 - 10.1038/s41598-019-50280-3

DO - 10.1038/s41598-019-50280-3

M3 - Article

C2 - 31604964

SN - 2045-2322

VL - 9

JO - Scientific Reports

JF - Scientific Reports

M1 - 14668

ER -