Cognitive load theory and teaching in primary care.

BECOMING A MASTER LEARNER Educating undergraduates to become master learners during primary care rotations is no easy task. Typically, attachment to primary care is short and often block-based with more time spent in hospital ward settings. Furthermore, there is often no continuum from primary to secondary care with learners having limited opportunities following patients along their journey. Educators in this domain have the added pressure of ensuring sufficient coverage of curricula in a condensed period of time. Add to this the often longstanding relationships built up between patients and their primary care doctors further exacerbating the issue with regards to the interaction between the learner and patient. When it comes to learning, adoption of learning theory is paramount.1 This is a vast field in itself but in essence, effective learning relies on several aspects. This may include recognition of learner autonomy and sense of relatedness, freedom for learners to explore their own ideas without unnecessary critique, safeguards to avoid too rapid a move to gain competency beyond the learner’s reasonable limits at a particular stage of training, self-reflection, feedback in a bi-directional non-judgemental fashion between educator and learner, creation of a safe learning environment, external peer-to-peer feedback, and self-directed learning . These aspects comprise various recognised learning theory domains such as self-determination and situated cognition. What is now apparent is that when delivering information, educators must ensure this is done in a way to ensure avoidance of information overload. Such loading of information, or more precisely cognitive load if done inappropriately, can hinder optimum learning through overconsumption of working memory available specifically for knowledge gain.