Document Type


Date of Degree

Spring 2016

Degree Name

PhD (Doctor of Philosophy)

Degree In

Psychological and Quantitative Foundations

First Advisor

Kathy L. Schuh


The analysis of human walking gait is a complex skill for physical therapy students to learn. As a result, students are at risk for a cognitive overload when confronted with these materials. Cognitive load consists of both intrinsic and extraneous loads as well as the germane processes that are required by the learners to process the information in working memory. As working memory is limited in its capacity to process new information, it is necessary to manage the cognitive load experienced by the learners. Intrinsic cognitive load is related to the complexity of the materials that must be learned and cannot be altered by instructional design without sacrificing initial understanding. An isolated elements instructional format purports to reduce the intrinsic CL experienced by learners by isolating the content into the individual elements prior to introducing any complex relationships that may exist between the elements. The purpose of this study was to examine the cognitive load and learning outcome effects of an isolated elements instructional format versus an interacting elements format when teaching observational gait analysis to physical therapy students.

A total of 72 students enrolled in a Doctor of Physical Therapy program participated in this study. Mixed factorial designs assessed both between-group and within-group outcomes. The independent variables were the group assignments (isolated or interacting) and time. The dependent variables were cognitive load and learning outcomes. Cognitive load was measured with 7-point Likert-type scales for both mental effort and task difficulty at five separate time points. Learning outcomes were assessed through performance scores and confidence ratings on a posttest and a 1-week follow-up test. Animated videos were used as the medium for instructional delivery. In the isolated elements group, the learners received the content in several separate videos that isolated each of the sub-phases of gait prior to viewing a summary video that included all of the interacting gait cycle components. Learners in the interacting elements group received the content in one video that included the full gait cycle followed by the same summary video.

Students in the isolated elements groups reported lower mental effort ratings immediately after viewing the isolated elements videos than did the interacting group after viewing the single video tutorial. However, there was no differences in either mental effort or task difficulty ratings at the other time points during the lesson or during the assessments. Performance scores and confidence ratings did not differ between the two groups. Within-group analyses found that there were significant changes over time in both groups for mental effort, performance scores, and confidence ratings. A statistically significant change was noted over time for task difficulty in the interacting elements group. The reduction in mental effort ratings immediately following the tutorial content for the isolated elements group lends support the theory that isolating the individual elements prior to teaching the complex interactions can reduce cognitive load for learners. However, this reduction in cognitive load did not translate into improved test scores or confidence compared to the interacting elements group. Future research is needed to identify instructional methods that can further reduce the cognitive load and increase the learning outcomes of students learning observational gait analysis. In addition, alternative objective methods of assessing cognitive load should be explored.

Public Abstract

The human brain can only manage so many tasks or ideas at one time. Cognitive load is the term used to describe the amount of information and processing that is required to learn new information or skills. When students are asked to learn complex new skills or information, it can be easy to overwhelm their thinking processes. For physical therapy students, learning to watch people walk and determine if they have an abnormalities in their walking is an example of a complex new skill.

The purpose of this study was to examine two different methods of teaching physical therapy students how to evaluate the walking of their patients. The first method divided the information in the lesson into smaller video portions, while the second method used a single, longer video to provide the same information. Both groups then viewed a summary video. Dividing the content of the lesson into smaller portions was hypothesized to decrease the cognitive load for the students and increase their test scores and confidence in their abilities.

The study found that students taught with the first method did report less mental effort after the tutorial content than those in the second group. Both groups were found to increase their ability to identify abnormal walking, but the groups scored similarly on the tests after the tutorials and a week later. Future studies should further explore the relationship between cognitive load and learning outcomes when teaching walking evaluation to physical therapy students.


publicabstract, Cognitive Load, Gait


xi, 107




Copyright 2016 Kelly J. Sass