Assessing student course evaluation comments through the lens of cognitive load theory: Insights for best teaching practices

Background: Cognitive Load Theory (CLT) explains how memory processes affect learning and retention. In healthcare education, managing complex knowledge, skills, and behaviors can overwhelm learners, underscoring the need for instructional designs that balance cognitive demands. Faculty and course evaluation (FCE) comments offer qualitative insights into student perceptions of instructional effectiveness. This study applies CLT to analyse FCE comments and identify instructional practices that support effective learning. Methods: Student FCE comments in a 3-year accelerated Doctor of Pharmacy (PharmD) programme (2019 – 2023) were anonymised, compiled into a text corpus, and analysed using a literature-derived CLT codebook. Three investigators conducted qualitative analysis to identify recurring cognitive load themes. Results: Codes were categorised into extraneous, intrinsic, and germane load elements. The most frequent theme involved instructional practices increasing extraneous load (400 codes), reflecting unnecessary cognitive burden. Supportive and organised teaching practices were linked to reduced extraneous load (321 codes). Simplified explanations and real-life examples were associated with minimising intrinsic load. Interactive and inclusive methods were identified as enhancing germane load (20 codes). Conclusion: Findings demonstrate how student experiences reflect CLT principles and offer guidance for improving instructional design. Applying CLT in healthcare education can foster more efficient, engaging, and meaningful learning environments.