{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:59:14Z","timestamp":1791493154686,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"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":["Int J of Urology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rapid adoption of robot\u2010assisted surgery has fundamentally altered urology training pathways. Although robotic platforms may reduce workload in experienced surgeons, these benefits may not extend to novice trainees. Apparent technical fluency during supervised console participation may conceal cognitive demands related to system control, anatomical interpretation, procedural sequencing, tissue handling, and team communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This review examined how cognitive load theory (CLT) can inform instructional design for novice trainees in robot\u2010assisted urologic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative review of the literature on CLT, surgical education, and urological training was conducted using PubMed and Google Scholar. The articles were selected based on their relevance to cognitive load management, surgical training, and video\u2010based learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings<\/jats:title>\n                    <jats:p>CLT distinguishes intrinsic load arising from task complexity, extraneous load arising from avoidable features of instruction or the environment, and cognitive resources devoted to schema construction. In novice trainees, unfamiliar interfaces and the simultaneous demands of console operation and procedural decision\u2010making may consume much of the available working memory capacity. CLT\u2010informed strategies\u2014including procedural segmentation, signaling, pre\u2010training, part\u2010task practice, scaffolded supervision, cognitive aids, and simulation\u2014may help align task demands with trainee expertise. A practical framework can structure instruction before surgery, provide brief prioritized guidance during surgery, and use focused debriefing afterward.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CLT provides a useful framework for robotic surgical education, but the current evidence is heterogeneous and not specific to all urologic settings. Prospective studies should determine whether CLT\u2010informed training improves learning, proficiency, and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70637","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T18:16:30Z","timestamp":1789409790000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Instructional Design for Surgical Novices Based on Cognitive Load Theory: Implications for Urologic Surgery Training"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3608-3931","authenticated-orcid":false,"given":"Sachiyo","family":"Nishida","sequence":"first","affiliation":[{"name":"Department of Urology, School of Medicine Sapporo Medical University  Sapporo Japan"},{"name":"Department of Patient Safety and Hospital Administration, School of Medicine Sapporo Medical University  Sapporo 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