Explaining emergency physicians’ capacity to recover from interruptions

Abstract

ObjectiveTo assess whether the capacity to utilize cues amongst emergency physicians is associated with differences in the capacity to recover performance following an interruption. BackgroundInterruptions 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. MethodThirty-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. ResultsEmergency 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). ConclusionThe 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. ApplicationAssessments of cue utilization may assist in the development of interventions to support clinicians in interruptive environments.