Exploring the Influence of Cognitive Load on Clinical Decision-Making in Dentistry: A Theoretical Approach

Abstract

This study explores the impact of cognitive load on clinical decision-making in dentistry, focusing on five key cognitive load dimensions: Mental Demand, Physical Demand, Temporal Demand, Effort, and Frustration. The primary objective of the study is to determine how these dimensions influence the quality, accuracy, and speed of clinical decision-making. The research employs a descriptive, cross-sectional design, utilizing the NASA Task Load Index (NASA-TLX) and clinical vignettes to assess cognitive load. Data was collected from a sample of 120 licensed practicing dentists from private, public, and university dental clinics. Participants engaged in clinical vignettes of varying complexity, followed by self-assessment of cognitive load using the NASA-TLX tool.
The results indicate that Temporal Demand is the most significant predictor of decision-making quality, with the highest mean and median scores among the cognitive load dimensions. Temporal Demand also exhibits a strong negative correlation with Clinical Decision Score, suggesting that increased time pressure reduces decision accuracy. Effort and Mental Demand are also critical dimensions, with higher levels of cognitive strain negatively impacting decision quality. Dentists working in university clinics reported the highest cognitive load due to the dual demands of clinical care and academic responsibilities. Notably, early-career dentists reported higher cognitive load, especially in the areas of Frustration and Mental Demand, compared to their more experienced counterparts.
The findings suggest that addressing cognitive load, particularly in the dimensions of Temporal Demand, Mental Demand, and Effort, can improve clinical decision-making. Reducing time pressure, optimizing workflows, and using decision-support systems can help alleviate cognitive strain. Training programs focused on cognitive load management, especially for early-career dentists, can further enhance decision quality. These findings emphasize the importance of reducing cognitive load to improve decision-making efficiency, minimize errors, and enhance patient safety in clinical dentistry.