Abstract：
Objectives: Cognitive load refers to the working memory resources required during a task. When the load is too high or too low this has implications for an individual\'s task performance. In the context of paramedicine and emergency medical services (EMS) broadly, high cognitive load could potentially put patient and personnel safety at risk. This systematic review aimed to determine the current understanding of the role of cognitive load in paramedical contexts.Methods: To do this, five databases were searched (Elsevier Embase, ProQuest Psychology, CINAHL, Ovid Medline, and Ovid PsychINFO) using synonyms of cognitive load and paramedical contexts. Included articles were full text, peer reviewed empirical research, with a focus on cognitive load and EMS work. Two reviewers screened titles, abstracts, and full text using a traffic light system against the inclusion and exclusion criteria. The quality of evidence was assessed using the GRADE framework. This study was registered on PROSPERO (CRD42022384246). No funding was received for this research.Results: The searches identified 73 unique articles and after title/abstract and full text screening, 25 articles were included in the final review. Synthesis of the research revealed 10 categories of findings in the area. These are clinical performance, cognitive processes, emotional responses, physical expenditure, physiological responses, equipment and ergonomics, expertise and experience, multiple loads, cognitive load measures, and task complexity.Conclusions: From these findings it was determined that there is agreement in terms of what factors influence cognitive load in paramedical contexts, such as cognitive processes, task complexity, physical expenditure, level of experience, multiple types of loads, and the use of equipment. Cognitive load influences clinical task performance and has a bi-directional relationship with emotion. However, the literature is mixed regarding physiological responses to cognitive load, and how they are best measured. These findings highlight potential intervention points where cognitive load can be managed or reduced to improve working conditions for EMS clinicians and safety for their patients.
摘要：
目标：认知负荷是指任务期间所需的工作记忆资源。当负载过高或过低时，这会影响个人的任务性能。在广泛的辅助医疗和紧急医疗服务(EMS)的背景下，高认知负荷可能会危及患者和人员的安全.本系统综述旨在确定当前对认知负荷在辅助医疗环境中的作用的理解。方法：要做到这一点，搜索了五个数据库(ElsevierEmbase，ProQuest心理学,CINAHL,OvidMedline,和OvidPsychINFO)使用认知负荷和辅助医疗环境的同义词。文章包括全文，同行评审的实证研究，专注于认知负荷和EMS工作。两名审稿人筛选了标题，摘要,和全文使用交通信号灯系统对照纳入和排除标准。使用GRADE框架评估证据质量。本研究在PROSPERO（CRD420223384246）上注册。这项研究没有收到任何资助。结果：搜索确定了73篇独特的文章，经过标题/摘要和全文筛选，最终审查中包括25篇文章。综合研究揭示了该领域的10类发现。这些是临床表现，认知过程，情绪反应,实物支出，生理反应，设备和人体工程学，专业知识和经验，多个负载,认知负荷措施，和任务复杂性。结论：从这些发现中可以确定，在医疗辅助环境中哪些因素影响认知负荷方面是一致的。比如认知过程，任务复杂性，实物支出，经验水平,多种类型的负载，以及设备的使用。认知负荷影响临床任务绩效，并与情绪具有双向关系。然而,有关认知负荷的生理反应的文献参差不齐，以及如何最好地测量它们。这些发现强调了潜在的干预点，可以管理或减少认知负荷，以改善EMS临床医生的工作条件和患者的安全。
