{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:07:59Z","timestamp":1790672879984,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess digital fatigue and multidimensional cognitive load, and to examine their associated factors among nursing students engaged in online learning in Jordanian universities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An Internet\u2010based questionnaire was distributed to undergraduate nursing students from governmental and private universities in Jordan between March and April 2025. Digital fatigue was measured using the Zoom Exhaustion and Fatigue scale, and cognitive load was measured using Leppink's Cognitive Load Scale. Associations were examined using bivariate tests, and a multiple linear regression analysis with bootstrapping was conducted to identify factors independently associated with extrinsic cognitive load.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 537 nursing students participated. Students reported relatively high levels of digital fatigue and cognitive load, with extrinsic cognitive load showing the pronounced ceiling effect. Digital fatigue was independently associated with extrinsic cognitive load after adjusting for demographic and academic characteristics. Academic year, type of university, and daily digital device use were also independently associated with extrinsic cognitive load, while age, sex, grade point average, device type, and Internet quality showed no significant associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Digital fatigue was independently associated with extrinsic cognitive load among nursing students, highlighting the role of instructional design in shaping students' cognitive experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Nurse educators should prioritise instructional strategies that reduce unnecessary cognitive demands in online learning environments, such as simplified navigation, reduced task\u2010switching, and structured pacing, to support nursing students' cognitive wellbeing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Digital fatigue and cognitive load remain underexamined among nursing students in resource\u2010limited settings. This study identifies extrinsic cognitive load as a modifiable, instructional\u2010design\u2010related factor, offering nurse educators a concrete target for improving online nursing education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology checklist for cross\u2010sectional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70795","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:55:55Z","timestamp":1788382555000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Digital Fatigue and Cognitive Load in E\u2010Learning: Evidence From Nursing Students in Jordan"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1797-5512","authenticated-orcid":false,"given":"Shaban","family":"Sinnokrot","sequence":"first","affiliation":[{"name":"Faculty of Nursing Zarqa University (ZU)  Zarqa Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5139-2788","authenticated-orcid":false,"given":"Randa","family":"Khirfan","sequence":"additional","affiliation":[{"name":"Health Management and Hospital Administration, Faculty of Nursing Middle East University  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1642-9763","authenticated-orcid":false,"given":"Ahmad I.","family":"Miqdadi","sequence":"additional","affiliation":[{"name":"Department of Community &amp; Mental Health Nursing, Faculty of Nursing Zarqa University  Zarqa Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4499-6236","authenticated-orcid":false,"given":"Yousef","family":"Abu\u2010Wardeh","sequence":"additional","affiliation":[{"name":"Department of Clinical Nursing, Faculty of Nursing Zarqa University  Zarqa Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4002-5675","authenticated-orcid":false,"given":"Ala'a Ayman","family":"Al\u2010yyan","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Zarqa University (ZU)  Zarqa Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9678-8693","authenticated-orcid":false,"given":"Qusai Abdulrahman","family":"AbuQamar","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Arab American University Palestine  Jenin Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-4876","authenticated-orcid":false,"given":"Nawras","family":"Fashafsheh","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Health Sciences Istanbul Gelisim University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"issue":"20","key":"e_1_2_14_2_1","first-page":"7423","article-title":"The Impact of Online Learning Fatigue on students' Continuous Use of Online Learning","volume":"102","author":"Alarabiat A.","year":"2024","journal-title":"Journal of Theoretical and Applied Information Technology"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10639\u2010020\u201010219\u2010y"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/ijnes\u20102022\u20100053"},{"key":"e_1_2_14_5_1","volume-title":"Four Causes for \u2018Zoom Fatigue\u2019 and Their Solutions","author":"Bailenson J. 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