Anatomy of the Carpal bones: "Solving the Carpal Conundrum: A Creative Approach to Remembering Carpal Bones". Applying Cognitive load theory. Ahmed Omar

Introduction:
When it comes to anatomy, there are certain structures that seem to defy easy memorization. One of these notorious challenges for medical students and professionals alike is the carpal bones, those small, intricate pebble-like structures nestled within the wrist. Fortunately, with a little creativity and imagination, you can make the process of remembering these bones a lot more enjoyable and effective. Below this narrative, I will elucidate how cognitive load theory can clarify the effectiveness of this metaphorical journey in enhancing the learning of anatomy. 

I will first start with the actual learning resource and story, and below that is the analysis:

A story to help learn and retain the names of the carpal bones:
The carpal bones, eight in total, form the wrists' joint. Memorizing their names and positions can be a daunting task, but here is a memorable story to help you conquer this challenge. Let's dive into the world of carpal bone mnemonics. You can use the picture below to help follow the story. 

Mission summary: Neil Armstrong has been tasked to go to the moon, collect some moon rock and come back to Earth, where he can go back playing his favorite sport, baseball. 

1. Neil Armstrong Lands on the Moon:
   - Neil ARMstrong (Radius/ Arm) lands on the moon (Lunate).
   - The first bone, the Lunate, is located at the base of the wrist and is often described as moon-shaped.

2. Next Bone Up - The Mission's Leader:
   - Continuing our lunar mission theme, the next bone up is Capitate, representing Neil Armstrong, the head of the mission. Capitate = Cappo. He is wearing a team leaders cap. Cap. Head in latin is also Caput.

4. Collecting Moon Rocks with a Hammer:
   - Moving along, the Hamate bone, resembling a hammer, is located above the Lunate, where the mission to use the hammer to collect moon rock.

5. Radial to the Lunate - A Spaceship:
   - The mission is over, now it is time go home using the spaceship,the radial side of the Lunate is the Scaphoid, which we remember as a spaceship (Scaphoid sounds like "ship").

6. From the Thumb to the Deux (2) Digit:
   - Starting from the thumb side, we have the TrapeziUM, which conveniently rhymes with "under the thUMb." 
  - TrapezoiD comes next, and we remember it as "D" for under the Deux (2) digit, or the index finger.
Neil Armstrong will use these two digits to skillfully guide the spaceship home. 

7. The Final Catch:
   - Two bones remain, and they might remind you of a baseball glove trying to catch a ball.
   - Triquetrum is remembered as "Try to catch," similar to "Tri-quetch" sound, and it's positioned next to the Pisiform, which is like a small ball or pea (P for Pisiform). 
Neil Armstrong is happily home and uses the time to play baseball in his local park. 

Conclusion:
The carpal bones may appear as an enigmatic jigsaw puzzle at first, but with mnemonic devices like this, you can turn them into an easily remembered story.

This approach can help you navigate the intricacies of the wrists' carpal bones, and can hopefully help both learners and practitioners.

Cognitive Load Analysis:
The Carpal Bones Mnemonic Narrative: The mnemonic narrative associates each carpal bone with a unique phase of Neil Armstrong's lunar mission, creating a structured storyline that assists in memorizing the bones' names and positions. This creative journey, from the moon landing to the triumphant return to Earth, symbolizes the carpal bones, making the learning process more engaging and memorable.

Introduction to Cognitive Load Theory:
In the realm of medical education, anatomy presents itself as a foundational yet complex subject, particularly when students approach the intricate structures of the carpal bones. These small, detailed elements that form the wrist joint are notoriously challenging for memorization and long term retention, esp. if not used in everyday practice.
This blog post introduced an innovative mnemonic narrative aimed at easing the recollection of these bones and evaluates its effectiveness using Cognitive Load Theory.

Cognitive Load Theory and Its Application to the Mnemonic:
Cognitive Load Theory (CLT), a very well know concept in educational psychology, describes the optimization of cognitive processing during learning. It asserts that our working memory has limited space for processing new information, necessitating instructional designs that respect this limitation. CLT identifies three types of cognitive load, which can be understood through the analogy of a weightlifter training for optimal performance:

1. Intrinsic Load:
   - Imagine intrinsic load as the basic weight of the barbell. It represents the inherent complexity or difficulty of the subject matter — in this case, the anatomy of the carpal bones. Just as a weightlifter cannot change the weight of the barbell, the intrinsic complexity of certain topics, like the carpal bones, is a given. However, just as proper technique can make lifting a barbell more manageable, effective instructional strategies, like our mnemonic, can make complex topics easier to understand.

2. Extraneous Load:
   - Extraneous load is like the unnecessary weight added to the barbell. It doesn't contribute to the weightlifter's growth and only exhausts them quicker. In learning, it's the cognitive load imposed by the way information is presented. It's the additional cognitive effort that learners expend when instructional design is cluttered or unclear. In our mnemonic, this load is reduced because the information is presented in a clear, sequential narrative, removing unnecessary cognitive weights that don't contribute to actual learning. The goal, like in weightlifting, is to reduce this unnecessary load as much as possible.

3. Germane Load:
   - Germane load, on the other hand, is like the weight a lifter adds to the barbell to increase muscle growth. It's the desirable load, the cognitive effort that contributes directly to the learning process. In the context of our mnemonic, germane load is increased as learners are encouraged to make connections between the story elements and the carpal bones. This active engagement is akin to adding beneficial weight that strengthens mental muscles, enhancing long-term retention. The objective is to maximize this type of load within the bounds of the individual's cognitive capacity.

Conclusion:
When examined through the lens of Cognitive Load Theory, the mnemonic narrative for the carpal bones can be an effective educational strategy. It aims to manage intrinsic load by simplifying complex information, minimizes extraneous load by trying to present a clear and engaging story, and also aims to optimize germane load by encouraging active and meaningful engagement with the content. This approach attempts to simplify the challenge of memorizing carpal bones and also to enhance the learning experience.
It highlights the importance of instructional designs that are mindful of cognitive limitations, aiming to reduce the extraneous while maximizing the germane load in medical education, much like a weightlifter who carefully chooses the right amount of weight to achieve optimal growth.

Dr. Ahmed Omar

References:

1. Office of Educational Improvement. "Cognitive Load Theory: A Guide to Applying Cognitive Load Theory to Your Teaching." Medical College of Wisconsin, 2022, www.mcw.edu/-/media/MCW/Education/Academic-Affairs/OEI/Faculty-Quick-Guides/Cognitive-Load-Theory.pdf. Accessed October 14, 2023.
2. Sherrington, T. (2021, October 23). A 5-minute guide to cognitive load theory. The Teaching Delusion. https://theteachingdelusion.com/2021/10/23/a-5-minute-guide-to-cognitive-load-theory/. Accessed October 14, 2023.