Impact of Cognitive Load on Clinical Decision-Making in UAE Undergraduate Health Science Students

Background: Clinical training demands integration of theoretical knowledge with practical skills, but high cognitive load may impair decision-making in health science students. Despite its significance, limited research from the United Arab Emirates (UAE) has examined this relationship. This study assessed how cognitive load impacts clinical decision-making among undergraduate health science students. Methods: This cross-sectional study examined 743 undergraduate health science students in United Arab Emirates during February–March 2025. Cognitive load was assessed using the Cognitive Load Scale (CLS), while clinical decision-making skills were measured using the Clinical Decision-Making in Nursing Scale–Patient Version (CDMNS-PT). Data were analyzed using IBM SPSS Statistics (Version 29). Bivariate analyses included Pearson’s correlations, independent samples t-tests, and Kruskal-Wallis tests with post-hoc analyses were performed. Regression analysis using generalized linear model (GLM) was employed. A p-value of < 0.05 was considered statistically significant in all the analyses. Results: Participants reported moderate cognitive load (Intrensic cognitive load: M = 11.50; extraneous cognitive load: M = 11.68) and decision-making skills (M = 124.35), with 90.6% showing low confidence. Females had higher cognitive load (p <.001), but no gender differences in decision-making. Higher extraneous cognitive load (ECL) predicted poorer decision-making (β=−0.19, p <.001), especially in “Search for Alternatives” (r = −.261). Top academically performing students (GPA = 3.1–4.0) scored 3.81 points higher in decision-making (p =.002) with 12–15% lower cognitive load (p <.001). Year 3 students excelled in decision-making (p =.007) and had the lowest cognitive load (p <.001). Pharmacy students outperformed peers (p =.014). Regression analysis confirmed ECL and academic performance as key predictors for clinical decision making (p <.001). Conclusion: Extraneous cognitive load and academic performance critically influence clinical decision-making skills. Reducing unnecessary cognitive demands and supporting academic performance may enhance competence. Interventions should target at-risk groups (e.g., females, early-year students) to optimize training outcomes.