Amy Brann  00:00

Ever feel like your brain is overloaded, struggling to make even the simplest decisions after a long day? Well, what if I told you that cognitive load, this mental strain of processing too much information or juggling too many choices, could be the silent culprit affecting everything from decision quality to emotional resilience, especially in those high stake moments. Well, today, we’re going to dive into how cognitive load shapes our decision making and why it can feel so overwhelming under pressure. We’ll tackle questions like, Should we just get more resilient? Is technology helping to reduce our cognitive load, or is it only adding to the noise, and crucially, how we can manage cognitive load to make clearer, more strategic decisions, we’re going to explore the research backed insights on how cognitive load impacts the brain with the practical tools for recharging our mental energy, simplifying our choices and even harnessing team support to lighten the mental load. Get ready for some actionable insights into mastering the mental demands of today’s fast paced world. Because when it comes to making decisions under pressure, a cognitive load that is lighter may just be your greatest insight. Gosh,

 

Dr. Jessie Gulsin  01:08

Amy, I’m looking forward to this one. Looking forward to having a reminder and some additional tips here. So yeah, cognitive load, it’s massive, isn’t it? What kind of problems do people encounter when they when they come and speak to you.

 

Amy Brann  01:23

It really is massive, and I’m really excited that the profile of it seems to have been raised. So now within my friendship groups that are not in this world are not spending their weekends researching this stuff, they’re also talking about cognitive load and unaware of it. I think the common questions are, can I reduce my cognitive load? Should I just get more resilient? And that often comes from leaders. You know, do people just need to be more resilient? There’s questions around tech and whether it’s reducing cognitive load or adding to it, and there’s questions about what the impact is. So does cognitive load impact our decision making? And I think the concerning thing about cognitive load for me is that it it can lead to errors, it can lead to reduced attention bandwidth. It can increase our reliance on stereotypes. And when our cognitive resources are overloaded, we can default to automatic processing, which can be great or can lead to more bias judgments decisions. So I think in today’s world, this more continuous partial attention, where lots of inputs from various places results in this continued partial attention can impair our working memory, reduce our cognitive flexibility and hinder our creative thinking. So there’s big stuff that’s affecting people, and when I’ve talked to leaders in organizations, one of the things that they cite is things like geopolitical stresses, additional concerns that are out there in the world that are adding to our mental fatigue and cognitive challenges, and people are self reporting these increased mental errors and difficulties with concentration following the end of the pandemic. So it’s massive. Jess, do you feel that you have ever experienced a high cognitive load? That’s a bit of a loaded question, because I’m I would be very surprised if you gave one answer here.

 

Dr. Jessie Gulsin  03:23

The short answer is absolutely yes. I think I’m very mindful of this with my kind of my day job, just because I’m obviously making some very important decisions which can be potentially life threatening. You know? I mean, it’s not an Amy kind of job where it’s all kind of systems go action all the time, but obviously, in general practice, you know, I’m making decisions which can be, can be very dangerous when it comes to certain medications, for example. So I’m very mindful of it. And I have things in place at work that I do and that I practice, which I’m sure we’re going to discuss because I’m so conscious of the fact that I don’t want to be making errors. I am very poor at doing this in my personal life, however, so I have this real kind of, maybe it’s like I’m living two lives, in a way, because at work, I’m very conscious of it, and I put things in place to protect myself and my brain and and then I leave work, and then I feel like it all goes out the window, and I don’t have those things in place in my personal life. Well, I, to a certain extent, I do, in the sense I have to keep myself well, to do my job properly. But I find, I think I just find it harder, because I guess the decisions I make outside of the workplace don’t seem as important, which is just ridiculous, really, isn’t it? Like, why do we place so much importance on work and we don’t see the fact that we need to have harmony on both sides? So yes, I definitely have a high cognitive load in arts. Yeah. Yeah,

 

Amy Brann  05:02

well, that doesn’t surprise me, especially with your work, but also running a home running, you know, running a son. You know, being a parent to a son, there’s a lot that comes with that cognitive load wise. So you said that you employ some techniques, some approaches at work, and I know you also, you work with your trainees, and you pass on things to them that you think could help them to manage when they’re you know, transitioning into this new role, there is a lot to take in, a lot to keep on top of. And as you say, a lot to do, a lot of responsibility to keep others safe through their decisions. So what would be some of the things that you that you do.

 

Dr. Jessie Gulsin  05:42

So one of the first things I talk about with my trainees, actually, when they’re new to general practice, is this concept of housekeeping. So Dr Roger neighbor is a very experienced general practitioner who coined this term, and it’s about resetting after an experience that has potentially not been very positive. So if I was to have a patient consultation that I didn’t think had gone very well, I do tend to beat myself up about these things, but what is important is that I actually just take stock, and I just have five minutes, probably less actually in a busy clinic, but I have a micro break, like a very small break, to just kind of have time out. Essentially, it’s just a time out, but it then allows me to then kind of move forward from that consultation so that I can be useful to the next patient in my next consultation, because I don’t want to hang on to those things and let it distract me. So I always try to encourage my trainees to keep this at the forefront of their mind when they first start, because it’s such a steep learning curve, the exponent. It’s an exponential learning curve, and and there’s so much to take on board all at all times of the day. But actually, when you’re feeling overwhelmed, or you feel like you know you’ve you are a bit overburdened. There’s no harm in then taking one minute, two minutes out to just housekeep

 

Amy Brann  07:08

and when. So I’m likening this to attention residue, which occurs when I describe it as opening up too many mental tabs. So on computers, often I look at someone’s screen and my word they’ve got Microsoft Teams open, and then they’ve got their emails open, and then they’ve got some sort of chat thing pinging up, and then they’ve got the things that they’re working on, and then the things that they’re going to work on, and the things that they really hope they might get to work on, but it’s really totally unrealistic. So it’s like that, having too many tabs open, and then our attention is jumping back and forth between those things. And when you are seeing multiple patients, I imagine you’re predisposed to exactly that, of leaving some of your attention with the first patient then going on to the second. So by the time you get to the last patient, you’ve got hardly any attention left for them. So this housekeeping sounds like it will help to mitigate that, much like we’d say in other forms of work, you know, closed down mentally. If there’s still more to do on it, make a note. Know that that’s secure. It’s out of your head. You don’t need to hold it in your working memory. Is there anything that guides what you do during that housekeeping time? Like, are you trying to think of nothing, or are you trying to think of something?

 

Dr. Jessie Gulsin  08:20

It depends, really. It depends on what I feel like I need. It may just, it may just be that I walk to the toilet and I tend to treat myself to a lubricate, yes, exactly. Or it may be that I go to the kitchen make myself a cup of tea. Or I might actually crave a bit of human contact, which is not necessarily, you know, focused on work. So I might just go out to the administrators or the secretaries and and just have a little conversation with them, and obviously try not to distract them too much, which I can be prone to do doing. But yeah, it’s just about removing myself. So maybe physically, either physically removing myself from that situation, or I do have a little area in my room, just a shelf where I’ve got some pictures that my son has drawn. I’ve got a nice plant. I’ve got some thank you cards there from patients and trainees. And I just swivel my chair and I just sit, and I just look, and I kind of have this moment of peace, and then I just swivel back to my computers. I say computers because I have two screens with multiple tabs up at all times. Yes, it’s either a physical removal or just like a mind kind of shift. But yeah, I mean, it’s, it’s not ideal, but it’s something, and it does help.

 

Amy Brann  09:39

Yeah, no, that sounds amazing. I love it. Okay, so housekeeping, that’s something that we can all do in a variety of different ways to help bring to a close, one experience, one type of work or interaction with someone before we then move on to the next. I love it because it will be a state change as well, which will be important, especially in your class. Of work you might be dealing with someone that has you’re giving really bad news to, and then you need to move on to the next patient and not be stuck in that empathetic space that that could be triggered by some of the things you’re dealing with. Okay, brilliant, right? Anything else? What else do you do?

 

Dr. Jessie Gulsin  10:21

I’ve got better at this one, actually, but I delegate. So when I was a new GP, I found it very hard to ask other people to do things. But as time has gone on and my workload has gradually crept up, I physically cannot do everything, and I do have to ask staff members to do certain things for me, whether that be to book a patient in for a follow up appointment. Or, you know, I got very used to typing up my own letters for a long time, but, you know, asking the secretaries to, perhaps, you know, type up dictations, for example. Or, yeah, it’s about utilizing the skill set of others and recognizing the value of others in your team. I think you know, I don’t, yes, I can’t ask anyone else to be the clinical brain on something, but I’ve got other colleagues in my practice who are skilled at what they do, and probably better, to be honest, like I’m rubbish when it comes to computers, for example. So anything techy like that, I am. I know who to go to, but breaking up tasks, asking for help, delegating. What can be delegated, I think is an important skill to learn.

 

Amy Brann  11:34

So I probably am best at that. In my home personal life, I try to make sure that at home, we’ve each got zones of responsibility, because it’s the remembering stuff that can be difficult. And I did joke this morning that I seem to be everyone’s extended executive function, because people were forgetting numerous things. And it’s like, Have you done this? Have you done that, and actually what I did suggest, because I’ve tried the list approach, and for some reason, lists aren’t always read in a way that leads to the desired action. And someone told me about this, a lovely lady I know locally who runs our Community Center. She says what saved her was using Alexa to remind her of what needed to happen that day. So when something pops into her head, she tells Alexa to remind her of when she needs to know about it. And then on school mornings, before they leave the house, she says, Alexa, what are the reminders for today? And Alexa has gathered them all up and then regurgitates. There be a better word than that, shares with her what it is that she needs to remember for the day. And I thought that was a really interesting way of using tech to support with that extended cognitive load, to take some of that. So that’s, yeah, an interesting piece. If those that you’re delegating to need some additional support, which sometimes might be more the case at home than at work, you’d hope at work people are good at taking those things off. Okay, so delegation housekeeping. Love it. Are there any other things that you find useful.

 

Dr. Jessie Gulsin  13:23

So one big thing, which I I noticed in the last kind of year or two, as I’ve had more trainees to look after at work, is about minimizing distractions. So the way that I work in my day is I’ll have my clinics, and I’ll have trainees that I’m supervising, and I’ll have some supervision slots blocked off, which means that they can come to me and they ask their queries. I think because I’m quite approachable, people were coming to me at multiple times throughout the day. And I think what I’ve tried to do now is, unless there’s a dire emergency, an acute medical emergency, I’ve tried to get the trainees to ask their questions at the end of my clinical session, if they need me to come in and review a patient with them, that’s fine, but I’ve also been very strict with myself that I will do that, but I must finish the task that I am doing at that time, because I you know, you’re more likely to make mistake mistakes the more you know that you’re distracted or interrupted. So I’ll finish typing up my notes, finish that referral, and then I will shift my mind to their query or their clinical question. So it’s about asking other people to be respectful of your boundaries and your time, which they are very good at once, that you know more often than not. Once you tell people what you need from them, they will give that to you. That to you, but unless they know that, they won’t. But also, from my point of view, I have tried to be a bit more stricter with how I manage these situations. So I think, yeah, I think that’s that’s one of the biggest things, the one of the biggest shifts that i. Have noticed an improvement with is minimizing those kinds of distractions. So

 

Amy Brann  15:05

I love this. I’m always well for I don’t know, it must be almost 20 years now, I’ve been telling people that distractions are so potentially draining for some types of work, they can be brilliant, you know, creative, lateral thinking. Yes, I see that. But for the majority of people, the majority of the working day, we would benefit from reducing distractions. I was on a call with a friend who runs a bathroom business this morning, and they have clients and prospective clients interrupting their work all day, every day. And of course, they want those interruptions. That’s why they exist, is so that they can, they can serve people in that way. And for many organizations that we’d work with, that collaborative piece that checking in, getting information from different people, is essential. But there are, there are ways for most people to ring, fence it and work in a different way, and I know with my team, we’ve been trying something different this year, which I don’t know was welcomed initially, the idea, and I probably didn’t explain the need or the intention well enough, but the idea that we respond to different ideas and questions throughout a general week for me, and the type of work that I often need to be doing is challenging when I’m in book writing or creation mode, or when I am deeply considering an organization’s challenges and working out what different science is good to apply to the challenge, to help solve it, or how we’re going to then communicate that to people so it’s engaging and inspiring and practical for them. I need to go deep into thoughts, and I don’t want to then be distracted by, you know, a marketing question or a logistics question. I need to batch those together into a time and so for us, having a document that people put those sort of questions in, that I can then check at a particular time of day or week, having regular meetings, so that we’ve got the opportunity to voice the bigger stuff and switch into that and do it justice. Because I was certainly finding when things were the piecemeal and all over the place, I wasn’t giving those different things the attention and energy that they deserved, because I was kind of in the middle of something else, so it was all just fractured and diluted. So I think working out what this looks like for you in your organization and in your home life is could really reduce some of the cognitive load. And I’m sort of sensing with this. There’s lots of different approaches, strategies, ingredients, there’s more in the synaptic spark sheet, if we experiment with them, then cumulatively, they could have really quite a big impact.

 

Dr. Jessie Gulsin  17:59

And I think, I guess it depends on, on the type of job you do. I mean, in my job, I can’t really escape decision making. It’s, you know, every 10 to 12 minutes, it’s constant. But I guess for others who are able to build in other kind of other aspects into the day, perhaps you have some decision free time in the day. I don’t know just just having a some scheduled time where you know that you’re not going to have to make any decisions, but you can work on other things. Perhaps,

 

Amy Brann  18:33

I think that’s really important. Decision making can be very draining for the brain. Some studies showed that decisions are not differentiated between. So, for example, even if you are choosing between a blue pen and a black paint, blue pen and black pen, that depletes the decision making capability like it counts as a decision whether you’re deciding which drug to give someone or really big, major life decisions, whether to move, whether to which school to send a child to. The big decisions seem to carry as much weight in these studies as the smaller decisions. And that then, for me, says, Well, then let’s reduce the number of decisions that we need to make and the things that we don’t need to be making a decision on a regular basis. Let’s standardize them. And I haven’t gone as far as to wear black all day, every day, although I have been tempted. But even with outfit choices, you know, I’ve outsourced that in the past. You on many occasions, for years, would be like, Oh, you’ve got this tool. Amy, wear this outfit. And I would frequently get compliments, and I’d say, oh, it’s not me. It’s my friend Jess, she tells me what to wear. Because it was for me that was a big source of stressful decisions. And I would go back and forth, and I’d have so many questions, it would take up such a lot of cognitive load that actually it sounds trivial, but, but for me, that was a huge thing. For other people, it might be i. Advanced decision making with food for other people, the research shows that if then approaches to decisions. So setting up, if this happens, then I do that can be really helpful for reducing cognitive load and making decisions that are less influenced by bias as well. Just for example, we get to the end of the day, we’re depleted. We are more likely to eat things that are less healthy for us. So could we make that decision in advance, and then towards to as the day progresses, be looking forward to whatever that yummy healthy thing is at the end of the day, rather than getting home, looking in the cupboards, going, oh my gosh, what am I going to cook and and then making a poorer decision. Yeah, absolutely,

 

Dr. Jessie Gulsin  20:42

yeah, meal planning, that’s a big one. It’s been on my list for a while, actually, because, yeah, exactly like you say, you get home and you’re knackered. I mean, I I’d like to say that I feed my child the most healthy, delicious meals, but actually, I think he’s better at school. The other day, came home that was really tired. I was really tired. I was like, right, you can have your chicken nuggets and chips, whatever, and so, Mommy, I had a tagine at school today. Don’t rub it in. But yeah, so I think, like, I like to say, reducing the burden by making those decisions and having, you know, maybe I just need to have the each day of the week and plan what meal I’m going to have and just stay the same. And, I mean, my son would be happy with that. But yes, I think that’s so important. It’s just having a broader, broader think about things. I think

 

Amy Brann  21:36

it’s, I think it’s taking that time to step back and maybe work out what the biggest pain points are, what the what the biggest areas of friction are, that which will be different for each of us, that if we address those things could be much better. So another friend this morning, Mo, made rice salad for the week. I think there’s some questions about whether you should keep rice for a week, actually, isn’t it 24 hours for rice? But anyway, Yep, she’s got it for the week. Let’s see how she goes. And she’s chopped up lots of vegetables and chickpeas, and it sounded amazing. And I was like, Oh, so it’s rice salad every day, is it? She said, Oh yes, but I could add tuna tomorrow. I could add chicken the next day. So she’s got her strategy that works for her, as long as she doesn’t get any rice poison effects. But she’s how she knows what she’s got, the decisions made the preppers done, and that’s an area of friction for her, and she takes her well being really seriously. So not having that would would cause more problems for me, like working well with with the team at synaptic potential was really important, so experimenting with what works for all of us to improve, that would be a big win for me. So maybe for you, I don’t know. It might be food, it might be something else that could be added into it. Okay, right? I know that you have some other things that you do to to reduce your cognitive load. Do you want to share any of the others?

 

Dr. Jessie Gulsin  23:10

Yes, I guess there’s two kind of other big things. So one is kind of more emotional, and one is more physical, you know, activity based. But obviously the kind of job I do, I’m hearing some quite harrowing things sometimes, and some very distressing things. And it goes back to housekeeping, I guess, but trying to manage my emotions surrounding specific cases, I still think back. I was talking to one of my colleagues, actually the other day, because we were talking about the on call rater, which is the emergency doctor afternoon on call. And it’s changed a lot, actually, since I was a trainee, but I still remember one particular on call where I felt really overwhelmed. The calls and patients were just piling in. It just looked horrendous from mid morning onwards, and I remember feeling so overwhelmed, and I started my calls, and I was making some good progress, but as fast as I did a you know, saw a patient, another one was booked in, and it just was getting it was snowballing, and I felt so overwhelmed, I burst into tears. And it was a cathartic to do that. And then, literally, within 10 seconds, I had to snap out of it, and I said to myself, jetty, you do not have time to cry. Save this for later. Kind of turn the tap off and plow on and carry on. But what I say to my trainees now is actually recognize that you know you’re feeling overwhelmed, recognize that, be kind to yourself, have a moment. And emotions can be good. They can be motivational. I mean, in that situation, the feeling of being overwhelmed is actually very motivating, because I thought I’m never going to leave work otherwise at this rate. So they can work in a positive way, and they can work in a negative way, of course, but trying to manage your emotions and. And, you know, I’m not saying don’t make time to cry, because I think it’s very important to cry, but, yeah, I think being a bit a bit kinder to myself is something that I’m getting better at doing as time goes on. I think that comes with experience. Obviously, I know much more about what I’m doing as a GP than when I first started, so I’ve got less of the kind of, you know the knowledge is is more solidified, and it’s there. And I know I found my feet as a GP, my patients will be glad to hear and I know what I’m doing, so I don’t feel so overwhelmed anymore. And then, actually, when you had a child, as you know, and your days are fraught and frantic, going to work is like a walk in the park, feel the stress anymore. So my life experiences have definitely changed. How I feel about those situations. But yes, managing emotions, I think, is quite important. Okay,

 

Amy Brann  25:52

so I’m hearing that the recommendation for anyone finding their job stressful is have a kid and then make some comparisons. It seems, ingestion, extreme solution, agreed, but that emotional regulation piece that sort of links into the question of, what is it just about resilience? Should we just be more resilient? And then cognitive load isn’t a problem, and I have some real challenges with that kind of approach. I think resilience is really important, but I also think compassion around the fact that resilience can go up and down in life due to a variety of factors is important to bear in mind people’s natural predisposition has an impact on how resilient we are able to be, but also sometimes the cognitive load that is persistently high when taken with the frames and the narrative that we are associating with, it can erode our resilience. And there’s links here. I don’t want to get too caught up in it, but there’s links, I think, to some of the studies that look at how we appraise, how we label stressful, challenging situations. So when you are back to back, you know that example you gave when you know, as fast as you tick a call off the screen and it disappears. You know, two more appear further down. That is a that is a objectively challenging situation. You know, it’s normal and natural to ask the question, Will I ever get through this? Will I ever finish helping all of these patients? Because mathematically, it’s not looking likely at this point, and so just being more resilient, I don’t think fixes that challenge. I think there could be structural things that need to be done. You need to know that calls stop being added at some point, even reminding yourself of that in those moments of this isn’t going to just keep going. I won’t be here all night. There will be a cut off point, and that then comes down to communication with your employer, in this instance, to make sure that your expectations are clear and the expectations on you. So it’s not that you’ve got to clear them all within the hour. Whatever it is, you know, it might be that you’ve just, for argument’s sake, you’ve got four hours. These will kept. This number will keep growing for the next two hours, but then no more will be added after that, and how you’re then able to appraise the situation and narrate what’s going on will be very different, and could then lead to an increase in resilience. However, if you don’t have those frames and those opportunities to think like that, then it will likely erode your resilience. So yes, resilience has got a real role to play in this, but things have have to be real. We can’t just almost pull our socks up and go, let’s be positive about this. I’m sure it’ll be fine. It has. You have to really be able to believe that it’s going to be fine. Does that make sense?

 

Dr. Jessie Gulsin  28:56

Absolutely, and like you say, it’s then putting things in place which are going to improve the situation. So you’ll be pleased to hear, as I’ve explained this to you before, I think in our conversations, but things are a lot better since, you know, a decade ago, when I was a trainee, because we have, yeah, we have more structure to the day. There is a cut off, you know, we’ve got to cap things, because it can become unsafe otherwise, and it’s about constantly reassessing and reevaluating. But it’s only happened because I’ve provided that feedback, and then my, you know, my bosses have listened to that. And so yeah, in some respects, it’s we all like a good moan. We like to kind of get things off of our chest. But actually, that’s not going to necessarily change anything, and unless you communicate it with the right people. So I agree with you. I find that this piece about resilience and oh, we just need to be more resilient. I think it’s a bit harsh actually, because we’re all going through stuff in life, and we do have to be kind to ourselves, and we’re all trying our best. So I think, yeah, we have to be sensitive and. Around that.

 

Amy Brann  30:03

Okay, yeah, no, I like that. You pulled out, sort of taking things back to people that can do something about it. In a lot of the organizations I work with, that responsibility piece and empowerment piece is sometimes misaligned. So I don’t know of any organizations that aren’t saying they want their people to be more proactive responsible, asking for forgiveness rather than permission. So there’s a real move in multiple different cultures around the world, from our perspective, towards that. But then how practically empowered people are to change some of the systemic pieces, some of the environmental pieces, some of the tech. You know, whether tech is helpful or hindering, I have seen it be both for sure and often, when we ask, when we examine challenges in organizations, we’re not we don’t just take a training based approach. Sometimes there’s training involved, but often there are systems that are causing friction, and if you can reduce those, then you release people. And I remember actually reading in the news not too long ago that a hospital doctor was saying one of the biggest friction points and challenges to their day was the number of systems they needed to log into just to help a patient. And I thought, Oh, my word. You know, it is not okay. And obviously I don’t know the ins and outs of how what it would take to change this. But of course, it’s not setting a medical profession who needs to have their brain really switched on up for success when they’ve got to log into five different things before they can get what they need to treat someone. So there are sometimes, yeah, other things, systemic things that can be done to help. And

 

Dr. Jessie Gulsin  31:49

that’s where I think tech can be really useful. I mean, we’ve got a partner at the moment who so he is very much on board with it, and he likes to figure out solutions to problems, but, you know, he said to me the other day, if you’re having the same issue over and over again, there’s going to be a solution to it, but I think you should make note of those issues so that I can get my thinking cap on and see if there’s a sustainable way to fix this. So it’s about being in tune with that. I think sometimes we’ve got so much going on, so many different challenges, and you just want to get them off your list, don’t you just want to crack on and get them done, but seeing if there’s patterns in the things that you’re doing which are causing you difficulties? Yeah, I guess we just need to be more aware of those, don’t we? I love

 

Amy Brann  32:40

it, and I think that’s a brilliant place to finish with that encouragement to reduce your cognitive load. Pause, take a step back and look at the patterns for where cognitive load is being depleted and is too high. Sorry, where your cognition is being depleted because your cognitive load is too high. And take a creative detective, curious based approach, like this partner you’re describing, that then can look at things with fresh eyes when you’re switched on, and go, Okay, if we were designing this differently, what would it look like in an ideal scenario? And it might be that some compromises need to be made, but at least then you know where you’re heading for and what could be done differently. Oh, brilliant. Thanks for all your insights, as usual, all of the stories of how it’s happening in your real world. So if you’ve enjoyed today’s episode, please do share it with a friend or colleague who might find it helpful as well. It’s one of the best ways to help us grow and reach more people like you that can make a positive impact. So make sure you’re following us on your preferred viewing or listening platform, so that you’re the first to know when we release a new episode. You.