Archives of Medicine and Health Sciences

: 2019  |  Volume : 7  |  Issue : 1  |  Page : 11--12

Learning with emotions: The relationship between emotions, cognition, and learning in medical education

Meghan McConnell 
 Department of Innovation in Medical Education; Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada

Correspondence Address:
Dr. Meghan McConnell
Departments of Innovation in Medical Education and Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario K1G 3Z7

How to cite this article:
McConnell M. Learning with emotions: The relationship between emotions, cognition, and learning in medical education.Arch Med Health Sci 2019;7:11-12

How to cite this URL:
McConnell M. Learning with emotions: The relationship between emotions, cognition, and learning in medical education. Arch Med Health Sci [serial online] 2019 [cited 2022 Sep 29 ];7:11-12
Available from:

Full Text


Emotions are an inherent part of medical education and lifelong clinical practice. Clinicians and trainees are regularly exposed to a wide range of emotions, such as fear of making a mistake, sadness over patient suffering, pride after making a successful diagnosis, or happiness following a positive patient outcome. Given the prevalence of emotions within medicine, medical educators have begun to acknowledge the potential impact of emotions on learning and education in medical trainees. Indeed, several researchers have provided empirical evidence that emotions can modulate student learning and achievement.[1],[2],[3] For example, Fraser et al.[1] found that when teaching medical students using a mannequin that subsequently “died,” trainees reported more negative emotions (upset, sad, depressed, and nervous) and received lower scores when presented with a similar simulated case 3 months later, relative to trainees whose mannequin “survived” the simulation. More recently, McConnell et al.[3] studied the impact of positive and negative emotions on learning basic physiology laws in novices. The authors found that individuals induced to experience either positive or negative emotional states performed significantly worse on both immediate and delayed (e.g., 1 week later) knowledge tests relative to individuals in the neutral emotion condition. Together, such findings demonstrate that emotions can influence how trainees learn and perform in academic settings. Having a better awareness of the interplay between emotions and learning is necessary for medical educators to understand how and when emotions influence what students learn.

 Influence of Emotions on Cognition

Theories within educational and cognitive psychology provide a foundation for understanding the relationship between emotions and learning.[4] A plethora of research has demonstrated that emotions influence a variety of cognitive processes that are necessary for learning to occur, such as the availability of cognitive resources, problem-solving strategies, memory for information, and students' interest/motivation to learn.[4],[5]

Availability of cognitive resources

Learning requires individuals to be able to dedicate cognitive resources to the to-be-learning material. An increasing body of evidence shows that both positive and negative emotions influence the availability of cognitive resources. More specifically, because people have limited cognitive resources, emotions that are unrelated to learning activities will consume cognitive resources, leaving fewer resources available for learning.[6] For example, Fraser et al.[2] examined the relationship between emotions, cognitive resources, and diagnostic performance during simulation training and found that (1) the demand on cognitive resources was highest when trainees reported high levels of “invigoration” and low levels of “tranquillity,” and (2) trainees' ability to accurately diagnose a trained murmur decreased as cognitive load increased. These results are among the first within medical education to demonstrate the impact of emotion and the availability of cognitive resources on performance during simulation training.

Problem-solving strategies

Perhaps one of the most well-studied areas in the emotion-cognition literature is the idea that emotions influence individuals' the types of cognitive strategies individuals' use to solve problems. Negative emotions are associated with the use of more detailed-oriented, analytical approaches to problem-solving, while positive emotions are associated with more flexible, creative ways of solving problems.[7] In this way, positive emotions are thought to promote deeper learning strategies, such as elaboration and organization of learning materials; on the other hand, negative emotions facilitate the use of more rigid learning strategies, such as simple rehearsal of to-be-learned material.[8],[9]


Emotional events and experiences tend to be recalled more readily than nonemotional events.[10] Research suggests that people are more likely to focus their attention on emotional content, and as a result, emotional information is prioritized during the initial stages of cognitive processing.[11],[12] Relatedly, positive and negative emotions differentially influence what information individuals attend to within their environment. Individuals in positive affective states attend to broader, more global features of the situation whereas those in negative states are more likely to pay attention to specific details of the scene.[13],[14] The influence of emotions on what people pay attention to have important implications for learning. Attending to more global features of learning activities facilitates memory for contextual or relational information, which helps learners integrate new information with prior knowledge, leading to better memory.

Interest and motivation

Finally, emotions influence learning and performance by promoting students' interest and motivation to learn.[15] Positive emotions, such as enjoyment and interest, can increase motivation and lead to greater engagement in learning activities; on the other hand, negative emotions, such as hopelessness and boredom, can have detrimental effects on motivation.[9] In this way, emotions can influence learning by inducing and sustaining students' interest in the learning material and motivation to learn, which can “spark further exploration or maintain learner investment when subsequent difficulties are encountered” (p. 289).[16]


Together, these findings briefly illustrate how emotions influence a variety of cognitive and motivational processes, all of which are crucial for learning. However, much of this research has been conducted within cognitive psychology laboratories, so the extent to which these findings can be generalized to medical education contexts remains to be seen. Given that clinical practice rarely occurs in an emotional vacuum, it is important to understand the role emotions play in learning and performance of medical trainees. Moreover, while medical educators acknowledge the prevalence of emotions during training, only recently have researchers begun to empirically examine when and how emotions influence learning and practice within medical education settings. As stated by Artino and Durning,[17] “if medical education researchers really want to improve medical education, we must broaden “what counts” as important and begin seriously exploring the role of emotion in learning (p. 275). By exploring the interplay between emotions and learning, medical educators will be better able to optimize learning in complex clinical environments.


1Fraser K, Huffman J, Ma I, Sobczak M, McIlwrick J, Wright B, et al. The emotional and cognitive impact of unexpected simulated patient death: A randomized controlled trial. Chest 2014;145:958-63.
2Fraser K, Ma I, Teteris E, Baxter H, Wright B, McLaughlin K. Emotion, cognitive load and learning outcomes during simulation training. Med Educ 2012;46:1055-62.
3McConnell MM, Monteiro S, Pottruff MM, Neville A, Norman GR, Eva KW, et al. The impact of emotion on learners' application of basic science principles to novel problems. Acad Med 2016;91:S58-63.
4Schutz P, Pekrun R. Emotion in Education. San Diego, CA: Academic Press; 2007.
5McConnell MM, Eva KW. The role of emotion in the learning and transfer of clinical skills and knowledge. Acad Med 2012;87:1316-22.
6Ellis H, Ashbrook P. Resource allocation model of the effect of depressed mood states on memory. In: Fiedler K, Forgas J, editors. Affect, Cognition and Social Behavior. Toronto: Hogrefe International; 1988. p. 25-43.
7Blanchette I, Richards A. The influence of affect on higher level cognition: A review of research on interpretation, judgement, decision making and reasoning. Cogn Emot 2010;24:561-96.
8Pekrun R, Frenzel A, Goetz T, Perry R. The control-value theory of achievement emotions: An integrative approach to emotions in education. In: Schutz P, Pekrun R, editors. Emotion in Education. Burlington, MA: Academic Press; 2007. p. 13-36.
9Pekrun R, Goetz T, Titz W, Perry RP. Academic emotions in students' self-regulated learning and achievement: A program of qualitative and quantitative research. Educ Psychol 2002;37:91-105.
10Buchanan TW. Retrieval of emotional memories. Psychol Bull 2007;133:761-79.
11Schupp HT, Stockburger J, Codispoti M, Junghöfer M, Weike AI, Hamm AO. Selective visual attention to emotion. J Neurosci 2007;27:1082-9.
12Nummenmaa L, Hyönä J, Calvo MG. Eye movement assessment of selective attentional capture by emotional pictures. Emotion 2006;6:257-68.
13Rowe G, Hirsh JB, Anderson AK. Positive affect increases the breadth of attentional selection. Proc Natl Acad Sci U S A 2007;104:383-8.
14McConnell MM, Shore DI. Upbeat and happy: Arousal as an important factor in studying attention. Cogn Emot 2011;25:1184-95.
15Ainley M. Connecting with learning: Motivation, affect and cognition in interest processes. Educ Psychol Rev 2006;18:391-405.
16Alexander P. A model of domain learning: Reinterpreting expertise as a multidimensional, multistage process. In: Dai, DY, Sternberg R, editors. Motivation, Emotion, and Cognition: Integrative Perspectives on Intellectual Functioning and Development. Mahwah, NJ: Lawrence Erlbaum; 2004. p. 273-98.
17Artino A, Durning S. It's time to explore the role of emotion in medical students' learning. Acad Med 2011;86:275.