Validation of a Semester-Level Adaptation of the Cognitive Load Scale Among Health Professions Students in Chile: A Cross-Sectional Study

The Cognitive Load Scale (CLS) is a widely used instrument for measuring intrinsic, extraneous, and germane cognitive load in a specific learning activity, but no validated Spanish-language version exists for health professions students in Latin America. This study aimed to adapt the CLS to a semester-level frame of reference (CLS-S), suitable for macro-curricular evaluation, and evaluate its psychometric properties among Chilean undergraduate health professions students. An observational, cross-sectional, and instrumental study was conducted with a non-probability sample of 1901 students from six health programs at a multicenter Chilean university. Following content validation by six experts, an exploratory factor analysis (EFA; n = 349) and confirmatory factor analysis (CFA; n = 1552) were performed, together with reliability estimation (Cronbach’s α and McDonald’s ω), measurement invariance testing between female and male students, and convergent validity analysis using Spearman correlations with the SISCO-II academic stress inventory. Content validity met the pre-specified criterion of Aiken’s V ≥ 0.8 for all items (observed range 0.833–1.000). The CFA confirmed the theoretical three-dimensional structure with an excellent fit (CFI = 0.989; TLI = 0.984; RMSEA = 0.0525; SRMR = 0.0220), high internal reliability (overall ω = 0.888), and strict measurement invariance between women and men. Scalar invariance was additionally supported across campus, academic programme, and academic year. Intrinsic and extraneous load was associated mainly with stressors, symptoms, and behavioral reactions, whereas germane load was the only dimension associated with coping strategies; all convergent correlations were small to moderate in magnitude. The semester-level Chilean CLS-S is a valid and reliable instrument, invariant for female–male comparisons, for evaluating the cognitive demands of curricular blocks in health professions education; its application to individual learning activities would require the separate validation of an activity-level version.