Explaining emergency physicians' capacity to recover from interruptions.


Journal

Applied ergonomics
ISSN: 1872-9126
Titre abrégé: Appl Ergon
Pays: England
ID NLM: 0261412

Informations de publication

Date de publication:
Nov 2022
Historique:
received: 25 03 2022
revised: 18 06 2022
accepted: 19 07 2022
medline: 23 10 2023
pubmed: 8 8 2022
entrez: 7 8 2022
Statut: ppublish

Résumé

To assess whether the capacity to utilize cues amongst emergency physicians is associated with differences in the capacity to recover performance following an interruption. Interruptions are implicated in errors in emergency medicine due to the cognitive load that they impose on working memory, resulting in a loss of performance on the primary task. The utilization of cues is associated with a reduction in cognitive load during the performance of a task, thereby enabling the allocation of residual resources that mitigates the loss of performance following interruptions. Thirty-nine emergency physicians, recruited at a medical conference, completed an assessment of cue utilization (EXPERTise 2.0) and an online simulation (Septris) that involved the management of patients presenting with sepsis. During the simulation, physicians were interrupted and asked to check a medication order. Task performance was assessed using scores on Septris, with points awarded for the accurate management of patients. Emergency physicians with higher cue utilization recorded significantly higher scores on the simulation task following the interruption, compared to physicians with lower cue utilization (p = .028). The results confirm a relationship between cue utilization and the recovery of performance following an interruption. This is likely due to the advantages afforded by associated reductions in cognitive load. Assessments of cue utilization may assist in the development of interventions to support clinicians in interruptive environments.

Sections du résumé

OBJECTIVE OBJECTIVE
To assess whether the capacity to utilize cues amongst emergency physicians is associated with differences in the capacity to recover performance following an interruption.
BACKGROUND BACKGROUND
Interruptions are implicated in errors in emergency medicine due to the cognitive load that they impose on working memory, resulting in a loss of performance on the primary task. The utilization of cues is associated with a reduction in cognitive load during the performance of a task, thereby enabling the allocation of residual resources that mitigates the loss of performance following interruptions.
METHOD METHODS
Thirty-nine emergency physicians, recruited at a medical conference, completed an assessment of cue utilization (EXPERTise 2.0) and an online simulation (Septris) that involved the management of patients presenting with sepsis. During the simulation, physicians were interrupted and asked to check a medication order. Task performance was assessed using scores on Septris, with points awarded for the accurate management of patients.
RESULTS RESULTS
Emergency physicians with higher cue utilization recorded significantly higher scores on the simulation task following the interruption, compared to physicians with lower cue utilization (p = .028).
CONCLUSION CONCLUSIONS
The results confirm a relationship between cue utilization and the recovery of performance following an interruption. This is likely due to the advantages afforded by associated reductions in cognitive load.
APPLICATION CONCLUSIONS
Assessments of cue utilization may assist in the development of interventions to support clinicians in interruptive environments.

Identifiants

pubmed: 35933839
pii: S0003-6870(22)00180-6
doi: 10.1016/j.apergo.2022.103857
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103857

Informations de copyright

Crown Copyright © 2022. Published by Elsevier Ltd. All rights reserved.

Auteurs

Emma C Falkland (EC)

Department of Psychology, Macquarie University, North Ryde, NSW, 2109, Australia. Electronic address: emma.falkland@mq.edu.au.

Mark W Wiggins (MW)

Department of Psychology, Macquarie University, North Ryde, NSW, 2109, Australia.

Heather Douglas (H)

Department of Psychology, Newcastle University, Callaghan, NSW, 2308, Australia.

Daniel Sturman (D)

School of Psychology, University of Adelaide, North Terrace, SA, 5005, Australia.

Jaime C Auton (JC)

School of Psychology, University of Adelaide, North Terrace, SA, 5005, Australia.

Lisa Shieh (L)

Department of Medicine, Stanford University, California, USA.

Johanna I Westbrook (JI)

Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2109, Australia.

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Classifications MeSH