Cognitive load score (CLS)
What is a cognitive load score?

Cognitive load score is the amount of cognitive effort applied to memorize, comprehend, and apply information contained within each clinical mind map. A distinct CLS is given to each mind map on this site and in the book. 

How is a cognitive load score calculated?
  1. First, a quotient is calculated by dividing the number of differential diagnoses around each patient presentation in a clinical mind map by the number of chunks used in the clinical mind map.   

  2. If this quotient, which is the number of differentials displayed in the clinical mind map divided by the number of chunks used in the clinical mind map, is less than 3 or greater than 7, the cognitive load score cannot be applied. If this quotient is greater than or equal to 3 and this quotient is less than or equal to 7, the cognitive load score can be applied. 

  3. Then the quotient, (Differentials/Chunks) is multiplied by the number of clinical features in the clinical mind map. The resulting final product is then called the cognitive load score.

Cognitive Load Score = Number of Differentials or Probable Diagnoses in the Clinical Mind Map Number of Chunks X Number of Clinical Features (Questions about Symptoms + Physical Exam Findings + Lab or Test Findings) in the Clinical Mind Map

In summary 

CLS = PD ÷ Chunks X CF

This cognitive load score is based upon cognitive load theory which suggests that working memory has limited capacity and only a finite number of items (5 plus or minus 2) can be held in working memory at any given time.

Why is the cognitive load score calculated this way?

This scoring method is used based upon cognitive load theory which states that the human brain can hold approximately 3 to 7 pieces of data in working memory at any given time.

The number of differentials around a patient presentation determines how difficult it may be to learn the approach to the patient. Chunking of these differentials makes the approach or the clinical mind map easy, and the number of distinct clinical features contained within each clinical mind map makes the task cognitively demanding. 

Who can use a cognitive load score?

Anyone using this book can use the cognitive load score. This cognitive load score is not a literature-based score, neither is it an attempt to rank order patient presentations based upon any level of difficulty. Instead, this cognitive load score simply provides an idea in terms of how busy a clinical mind map may be. Learners can look at the cognitive load score before studying a clinical mind map and determine approximately how much time they may need to spend to gain full comprehension of the clinical mind map. Educators can use the cognitive load score to create assignments and allot time to certain topics based upon perceived level of difficulty.

Cognitive load score table is provided below for all the mind maps on this site and in the book. 

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