Applying Cognitive Load Theory to Best Practices in Pharmacy Education: A Narrative Review.

OBJECTIVE: Cognitive Load Theory (CLT) provides a science-based framework for optimizing learning in pharmacy education by aligning instructional design with human cognitive architecture. This narrative review synthesizes evidence on how CLT principles can inform instructional strategies, curriculum design, assessment practices, and faculty development within Doctor of Pharmacy (PharmD) programs. FINDINGS: CLT differentiates among intrinsic, extraneous, and germane cognitive load, each influencing how learners process, integrate, and apply information. Managing intrinsic load through segmentation, scaffolding, worked examples, pre-training, and stepwise increases in task fidelity supports schema development in complex basic and clinical sciences. Reducing extraneous load by streamlining instructional materials, applying multimedia design principles, providing clear instructions, and eliminating irrelevant details enhances working-memory efficiency across lectures, skills labs, OSCEs, and simulation-based activities. Promoting germane load through active learning, retrieval practice, structured debriefing, concept mapping, self-explanation, and reflective activities strengthens schema construction and deep learning. At the curricular level, CLT supports intentional sequencing from foundational sciences to integrated pharmacotherapy and practice readiness, aligning with ACPE Standards 2025. In assessment, CLT principles inform clear exam items, well-structured OSCE stations, appropriate fidelity progression, and feedback that supports learning without adding cognitive burden. Effective implementation also requires faculty development, including CLT-focused workshops, peer review, simulation debriefing training, and collaborative lesson redesign to promote consistent, cognitively efficient instruction. SUMMARY: CLT offers an integrative framework to enhance teaching, curricular coherence, assessment quality, and faculty instructional effectiveness. Embedding CLT across these domains can improve learning efficiency, reduce unnecessary cognitive burden, and support the development of adaptive, practice-ready pharmacists.