Reducing cognitive load for simulation facilitators: A cross-sectional pilot study

Background: High-quality simulation relies on skilled facilitators who manage multiple, overlapping responsibilities.Throughout a simulation, facilitators must maintain psychological safety, monitor learner performance, provide real-time cues, troubleshoot technology, and prepare for a robust debrief.These competing demands create significant cognitive load, which can affect facilitator performance and learner outcomes.Reducing cognitive load may strengthen facilitator readiness to lead these high-stakes scenarios.This project aimed to examine the cognitive demands placed on facilitators and identify strategies to mitigate their impact.Methods: About 24 facilitators completed a nine-item survey to assess the tendency to become overwhelmed when managing the number of associated tasks of a simulation, cognitive strain, and confidence with managing unexpected events and/or learner responses during simulation.Based on the findings, we developed two strategies: (a) cofacilitation, and (b) structured pre-and debriefing forms to mitigate their cognitive load and gathered feedback on their impact.Results: Findings show that facilitator cognitive load is multidimensional, influenced by scenario complexity, learner dynamics, technology, and emotional regulation.Both novice and experienced facilitators reported distinct stressors, highlighting the need for tailored support across experience levels.About 91% reported the structured pre/debrief forms were very helpful or extremely helpful.About 79% reported cofacilitation significantly or slightly decreased their cognitive load.Conclusion: This project lays the groundwork for further understanding facilitator cognitive load and targeted interventions to reduce it in simulation-based education.By addressing specific stressors, we can enhance facilitator performance and promote sustainable simulation practices.