SHM Converge Scientific Abstract ePoster Gallery-Cognitive Challenges in Cross-Coverage Patient Care

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This study examined how trainees perceive the cognitive demands of cross-cover care, the inpatient responsibility of caring for hospitalized patients when the primary team is unavailable. Using Cognitive Load Theory, the authors explored how trainees experience different types of load during cross-cover and whether these challenges differ by training level.<br /><br />The study surveyed 329 trainees at one institution in February 2023 with an anonymous electronic questionnaire based on 15 challenges identified in prior qualitative interviews. The response rate was 48% (158 respondents). The researchers compared responses between PGY1 and PGY2 trainees using t-tests.<br /><br />Results showed that most of the impact of cross-cover challenges was attributed to extraneous cognitive load, meaning burdens caused by inefficient processes rather than the task itself. Several differences between PGY1 and PGY2 trainees were statistically significant. PGY1 residents reported greater difficulty with lack of medical knowledge, lack of knowledge of hospital processes, and delays in calling attendings or consultants overnight.<br /><br />The authors conclude that understanding cross-cover through the lens of Cognitive Load Theory may help reduce challenges, support learning, and improve patient care. Suggested interventions include tailoring cross-cover responsibilities to the trainee’s experience level to reduce intrinsic load and improving workflows and role clarity to reduce extraneous load. Future work should test targeted interventions aimed at improving education and patient safety.

Asset Subtitle

Molly M. McNeely

Meta Tag

Author List Alexandra Vinson, Catherine McDermott, David Hughes, Lauren Heidemann, Molly M. McNeely, Russel Hathaway, Sarah Hartley

Category Research

Concept Cognitive Load Theory

Concept Cross-Cover Care

Concept Extraneous Load

Concept Cross-Cover Challenge

Concept Cognitive Load

Distinguished Finalist

Presenter Organization University of Michigan

Presenting Author Molly M. McNeely

Track Education

Keywords

cross-cover care

cognitive load theory

trainee perceptions

inpatient responsibility

PGY1 residents

PGY2 residents

extraneous cognitive load

medical education

patient safety

hospital workflows

Cognitive Load Theory

Cross-Cover Care

Extraneous Load

Cross-Cover Challenge

Cognitive Load