Impact of multiple educational technologies on well-being: the mediating role of digital cognitive load | BMC Nursing

This study addressed the role of digital cognitive load in mediating the relationship between healthcare students’ well-being and their active use of multiple educational technology platforms. At the outset, the correlation results showed that the well-being of health sciences students was negatively correlated with the usage of multiple educational technology platforms and digital cognitive load. The mediation analysis’s results explained these findings with the direct effect of multiple educational technology platforms’ usage and digital cognitive load on healthcare students’ well-being (−0.234) and (β = − 0.185), respectively. According to the linear regression model, the addition of digital cognitive load and multiple educational platforms explained 40.4% of the variation in student well-being.

Several studies support this finding. A literature review reported a negative correlation between educational technology use and well-being, notably when insufficient training exacerbates user stress [32]. Thus, unfulfilled technological potential may increase anxiety and lower student satisfaction. This is further supported by a study among 174 healthcare students, which showed that while educational technologies may enhance academic outcomes, they do not automatically lead to improved emotional or psychological states. Poor technology integration can even contribute to stress among students [33]. Tokuç and Varol emphasize that the rapid evolution of medical education technology can lead to increased anxiety among learners who feel unprepared to utilize these tools effectively, thus impacting their educational experience and overall well-being [34]. A cross-sectional study conducted among 192 undergraduate medical and nursing students found that excessive screen time for academic purposes increases fatigue and anxiety and reduces performance [34]. Furthermore, a qualitative descriptive study in Indonesia indicates that online learning affects social and emotional behavior, resulting in decreased cooperation among students due to diminished tolerance, limited social interaction with peers, and children’s emotions often manifesting as boredom and sadness [35].

This can be attributed to several underlying factors, including technostress, excessive screen time, inadequate support systems [36], a lack of empathy from teaching staff, and insufficient training for staff on educational tools [37, 38]. Additionally, varying levels of digital literacy among healthcare students can make it difficult for some to use these platforms efficiently [39, 40]. These factors lead to student frustration and unmet expectations during online learning, which collectively contribute to mental and physical health challenges among students. This necessitates a more holistic approach wherein medical education institutions invest in technology and provide adequate support and training for students and educators to mitigate stress and enhance emotional well-being. The forthcoming studies on digital platforms designed to improve student well-being illustrate a need for user-centered designs that prioritize and integrate students’ mental health within the educational technology framework [41].

Conversely, a Johnson & Hall (2020) study argues that well-structured e-learning platforms can enhance knowledge retention and engagement. Digital tools also provide flexibility, allowing students to learn at their own pace, which can benefit self-directed learning. Some platforms even encourage collaboration through discussion forums and real-time group work, which can foster peer support and help alleviate stress. These opposing views suggest that the issue may not be technology but how it is implemented.

The research indicated that digital cognitive load adversely affects student well-being, especially among healthcare students, who frequently encounter high-pressure, rapid learning settings necessitating concurrent mastery of intricate theoretical concepts and actual clinical competencies. The responsibilities of overseeing many instructional platforms, such as simulations, patient care modules, and virtual laboratories, may exacerbate cognitive strain, rendering this demographic particularly susceptible to the adverse effects of digital overload. This study corresponds with a survey on cognitive load and mental health, which revealed that elevated cognitive load during academic work heightens stress and diminishes general well-being, especially in challenging learning contexts [42]. A study aimed at examining the correlation between the online learning environment and the mental health of university students revealed that elevated cognitive load during virtual academic assignments exacerbates stress and diminishes overall well-being among these students [43]. A paper examining the interplay between cognitive load theory, intrinsic motivation, and emotions in health professions education revealed that elevated cognitive load adversely affects student well-being and emotional health [44]. A randomized trial published results that challenge the idea that immersion is always beneficial. In their study on surgical training, immersion and virtual reality training methods could be identified as contributors to excessive extraneous load [45].

A study on cognitive load theory supports this assertion, indicating that excessive information processing via electronic devices might overload working memory, resulting in stress and diminished comprehension [46]. Research suggests that extended screen use and multitasking in educational environments lead to increased anxiety and decreased academic motivation among students [47]. These findings indicate that digital cognitive load must be meticulously regulated to enhance student well-being. A study among undergraduate medical and nursing students in Morocco indicated a strong association between healthcare students’ state anxiety and cognitive load [48].

Multiple factors influence the correlation between digital cognitive load and student well-being. The intricacy of digital resources, the caliber of online education, personal learning styles, and time management abilities all significantly influence outcomes [49]. The availability of digital resources and the level of self-regulation in students’ study habits can affect their capacity to manage digital cognitive demands. Our suggestion is backed by the findings of a study in the United Arab Emirates that indicated that college students with robust digital skills may more effectively navigate online courses, interact with digital learning platforms, and participate in virtual classroom activities, whereas those deficient in digital literacy may encounter increased cognitive load, resulting in stress and diminished academic satisfaction [39].

Conversely, several research studies counter this correlation, asserting that digital tools can augment learning and alleviate cognitive strain when applied appropriately. Mayer and Moreno (2017) established that structured digital learning environments incorporating multimedia enhance information retention without necessarily elevating cognitive burden [50]. Furthermore, a study conducted by Zheng et al. (2021) emphasizes that adaptive e-learning systems can customize information delivery, alleviating the cognitive load on students [51]. These results indicate that the adverse effects of digital cognitive load may not be ubiquitous and can be alleviated by well-designed digital interfaces. Educators and institutions must implement proactive initiatives to resolve this issue. Establishing organized digital learning platforms, enhancing digital literacy, and employing cognitive load management techniques such as information segmentation, minimizing unnecessary content, and encouraging active learning can alleviate negative impacts. Promoting regular digital-free activities, enhancing mental health awareness, and improving the balance between digital and traditional learning techniques can also encourage student well-being [52].

The study reported that digital cognitive load positively correlates with adopting various educational technology platforms in learning environments. Moreover, it mediated the relationship between using multiple educational platforms and students’ well-being. Digital cognitive load increases among students who reported increased usage of different platforms. This aligns with the results of many researchers [23].

This result could be backed by previous studies’ conclusions that university students must navigate numerous workflows, interface with various technologies, and maintain concentration due to the proliferation of resources [16, 23, 35, 37, 49]. These platforms enhance accessibility, engagement, and personalized learning. Yet, they also elevate cognitive load due to the necessity of navigating several interfaces, recalling multiple credentials, and adjusting to diverse pedagogical approaches. Focusing on content instead of platform logistics is impeded by working memory deficits, decision fatigue, and fragmented attention resulting from platform changes [53, 54]. The utilization of various technologies increases cognitive load, causing learners to concentrate on technology rather than the subject matter [55]. This overload may induce mental fatigue, diminished recall, and reduced motivation, particularly in less digitally literate students [56].

No previous studies assessed digital cognitive load as a mediator between study variables with which to compare our results. However, a study conducted among undergraduate healthcare students reported that healthcare students had many similar experiences of cognitive load in online learning compared to their neurotypical peers, such as difficulties in asking questions, stress caused by assessments, confusion in navigating the content, and having to deal with technical issues [57]. Another cross-sectional study from seven medical colleges in Islamabad, Pakistan, among 633 medical students showed that the total cognitive load score partially mediated the relationship between digital literacy and academic self-efficacy [58].

Therefore, it is prudent to integrate digital technologies in a structured manner to enhance students’ performance rather than to exacerbate assignment workloads. It is recommended that the appropriate use of multiple types of technology be integrated with various teaching and learning methods that necessitate interaction and communication between students and their instructors. It is imperative to devise a strategy that enables the selection of appropriate platforms for achieving the course requirements from a wide range of alternatives.

This study not only validates previously noted correlations between educational technology utilization and student well-being but also enhances comprehension by recognizing digital cognitive load as a mediating factor. Previous research has demonstrated that excessive or inadequately integrated digital tools can result in worry, weariness, or diminished academic performance, although they frequently fail to elucidate the mechanisms by which these impacts manifest. Our findings experimentally validate that the mediating function of digital cognitive load indicates it is not alone the utilization of numerous platforms affecting students’ well-being, but rather the mental work necessary to navigate these tools that is crucial. Our findings corroborate and enhance prior observations within the field of medical and healthcare education, highlighting the importance of structured digital integration and cognitive support systems, specifically in these academic settings. Our work not only coincides with but also significantly extends current studies in instructional technology and student mental health.

Future research must prioritize longitudinal and comparative studies, including healthcare students, to more effectively elucidate the profession-specific cognitive and emotional obstacles inherent in digital learning environments.