Abstract In medical training, allowing learners to take pauses during tasks is known to enhance performance. Cognitive load theory assumes that insertion of pauses positively affects cognitive load, thereby enhancing performance. However, empirical studies on how allowing and taking pauses affects cognitive load and performance in dynamic task environments are scarce. We investigated the pause effect, using a computerized simulation game in emergency medicine. Medical students (N = 70) were randomly assigned to one of two conditions: simulation with (n = 40) and without (n = 30) the option to take pauses. All participants played the same two scenarios, during which game logs and eye-tracking data were recorded. Overall, both cognitive load and performance were higher in the condition with pauses than in the one without. The act of pausing, however, temporarily lowered cognitive load, especially during intense moments. Two different manifestations of the pause effect were identified: (1) by stimulating additional cognitive and meta-cognitive processes, pauses increased overall cognitive load; and (2) through relaxation, the act of pausing temporarily decreased heightened cognitive load. Consequently, our results suggest that in order to enhance students’ performance and learning it is important that we encourage them to utilize the different effects of pausing.

中文翻译：

---

医学模拟游戏中暂停对认知负荷的不同影响

摘要 在医学培训中，众所周知，允许学习者在任务期间暂停可以提高表现。认知负荷理论假设插入停顿会对认知负荷产生积极影响，从而提高表现。然而，关于允许和采取暂停如何影响动态任务环境中的认知负荷和表现的实证研究很少。我们在急诊医学中使用计算机模拟游戏研究了暂停效应。医学生 (N = 70) 被随机分配到以下两种条件之一：模拟有 (n = 40) 和没有 (n = 30) 暂停选项。所有参与者都玩了相同的两个场景，在此期间记录了游戏日志和眼动追踪数据。总体而言，有停顿的情况下的认知负荷和表现都高于没有停顿的情况。然而，暂停的行为，暂时降低认知负荷，尤其是在紧张时刻。暂停效应有两种不同的表现形式：（1）通过刺激额外的认知和元认知过程，暂停增加了整体认知负荷；(2) 通过放松，暂停的行为暂时降低了认知负荷。因此，我们的结果表明，为了提高学生的表现和学习，重要的是我们鼓励他们利用停顿的不同影响。暂停的行为暂时降低了认知负荷。因此，我们的结果表明，为了提高学生的表现和学习，重要的是我们鼓励他们利用停顿的不同效果。暂停的行为暂时降低了认知负荷。因此，我们的结果表明，为了提高学生的表现和学习，重要的是我们鼓励他们利用停顿的不同效果。