Explaining emergency physicians' capacity to recover from interruptions. (November 2022)

• Record Type: Journal Article
• Authors: Falkland, Emma C.; Wiggins, Mark W.; Douglas, Heather; Sturman, Daniel; Auton, Jaime C.; Shieh, Lisa; Westbrook, Johanna I.
• Is Part Of: Applied ergonomics. Volume 105(2022)
• Publication Date: 2022-11
• Subjects: Human engineering -- Periodicals; 620.82
• DOI: 10.1016/j.apergo.2022.103857
• Languages: English
• ISSNs: 0003-6870

Abstract

Abstract: 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: 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: 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: 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: 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: Assessments of cue utilization may assist in the development of interventions to support clinicians in interruptive environments. Highlights: Emergency physicians with a greater capacity for cue utilization display less loss of performance following an interruption. A greater capacity for cue utilization affords an advantage through the availability of residual cognitive resources. To manage interruptions effectively, residual resources might be directed towards the rehearsal of the suspended task. Assessments of cue utilization may enable the development of methods to support the individual needs of emergency physicians.