ISSUE: The transfer of a @entity1 from one clinician to another is a high-risk event. Errors are common and lead to @entity1 harm. More effective methods for learning how to give and receive sign-out is an important public health priority. EVIDENCE: Performing a handoff is a complex task. Trainees must simultaneously apply and integrate clinical, communication, and systems skills into one time-limited and highly constrained activity. The task demands can easily exceed the information-processing capacity of the trainee, resulting in impaired learning and performance. Appreciating the limits of working memory can help identify the challenges that instructional techniques and research must then address. @entity73 ( @entity73 ) identifies three types of load that impact working memory: intrinsic (task-essential), extraneous (not essential to task), and @entity9877 (learning related). The authors generated a list of factors that affect a trainee's learning and performance of a handoff based on @entity73 . The list was revised based on feedback from experts in medical education and in handoffs. By consensus, the authors associated each factor with the type of cognitive load it primarily effects. The authors used this analysis to build a conceptual model of handoffs through the lens of @entity73 . IMPLICATIONS: The resulting conceptual model unpacks the complexity of handoffs and identifies testable hypotheses for educational research and instructional design. The model identifies features of a handoff that drive extraneous, intrinsic, and @entity9877 load for both the sender and the receiver. The model highlights the importance of reducing extraneous load, matching intrinsic load to the developmental stage of the learner and optimizing @entity9877 load. Specific @entity73 -informed instructional techniques for handoffs are explored. Intrinsic and @entity9877 load are especially important to address and include factors such as knowledge of the learner, number of @entity1 , time constraints, clinical uncertainties, overall @entity1 /panel complexity, interacting comorbidities or therapeutics, experience or specialty gradients between the sender and receiver, the maturity of the evidence base for the @entity1 's disease, and the use of metacognitive techniques. Research that identifies which cognitive load factors most significantly affect the learning and performance of handoffs can lead to novel, contextually adapted instructional techniques and handoff protocols. The application of @entity73 to handoffs may also help with the further development of @entity73 as a learning theory.

Unpacking the Complexity of XXXX Handoffs Through the Lens of Cognitive Load Theory.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity73 :: ('MESH:D003072', 'Disease') :: ['CLT', 'Cognitive load theory'] @entity9877 :: ('CHEBI:30443', 'Chemical') :: ['germane']
@entity1 :: (9606,Species) :: ['Patient']
