Handover between colleagues is a complex task. The problem is that handovers are often inadequate because they are not structured according to theoretically grounded guidelines. Based on the cognitive load theory, we suggest that allowing a clarifying dialogue and thereby optimizing germane cognitive load enhances the information quality and diagnostic accuracy at handover, but may prolong handover duration. We also expect that mentioning key information first and thus decreasing intrinsic cognitive load improves information quality and diagnostic accuracy. We developed two representative paediatric cases for presentation in a factorial 2 × 2 design. Sixth-year medical students (N = 80) were randomly assigned to one of four groups that differed with regard to how the case histories were delivered to them (chronological order versus key information mentioned first) and direction of information exchange (unidirectional versus a clarifying dialogue). The receivers of the handover were asked to write a report of the cases and suggest the best diagnosis. Dependent variables were information quality of the written report (Information score), quality of the diagnosis (Diagnostic accuracy score) and the time it took to deliver the written handover case report (Handover report duration). Seen through the lens of cognitive load theory, allowing a clarifying dialogue at handover, and thus optimizing the germane cognitive load, significantly increased the Information score (p < 0.0005), Diagnostic accuracy score (< 0.05) and Handover report duration (p < 0.001).

中文翻译：

---

隔离关键信息并允许澄清问题如何提高儿科病例移交时的信息质量和诊断准确性

同事之间的交接是一项复杂的任务。问题是移交通常是不充分的，因为它们不是根据基于理论的指南构建的。基于认知负荷理论，我们建议允许澄清对话并从而优化相关认知负荷可以提高交接时的信息质量和诊断准确性，但可能会延长交接时间。我们还期望首先提及关键信息，从而减少内在认知负荷，从而提高信息质量和诊断准确性。我们开发了两个具有代表性的儿科病例，以采用析因 2 × 2 设计进行展示。六年级医学生 (N = 80) 被随机分配到四组中的一组，这四组在向他们提供病历的方式（时间顺序与首先提到的关键信息）和信息交流的方向（单向与澄清）方面有所不同对话）。移交的接收者被要求写一份病例报告并提出最佳诊断建议。因变量是书面报告的信息质量（信息评分）、诊断质量（诊断准确性评分）和交付书面移交案例报告所需的时间（移交报告持续时间）。从认知负荷理论的角度来看，允许在交接时进行澄清对话，从而优化相关认知负荷，显着提高了信息得分 (p < 0.0005)，