Abstract
Multitasking is an essential skill to develop during Emergency Medicine (EM) residency. Residents who struggle to cope in a multitasking environment risk fatigue, stress, and burnout. Improper management of interruption has been causally linked with medical errors. Formal teaching and evaluation of multitasking is often lacking in EM residency programs. This article reviewed the literature on multitasking in EM to identify best practices for teaching and evaluating multitasking amongst EM residents. With the advancement in understanding of what multitasking is, deliberate attempts should be made to teach residents pitfalls and coping strategies. This can be taught through a formal curriculum, role modeling by faculty, and simulation training. The best way to evaluate multitasking ability in residents is by direct observation. The EM Milestone Project provides a framework by which multitasking can be evaluated. EM residents should be deployed in work environments commiserate with their multitasking ability and their progress should be graduated after identified deficiencies are remediated.
Highlights
Multitasking is a core skill in emergency medicine (EM)
In the 2011 update on the Clinical Practice of EM [7], multitasking was defined as the ability to prioritize and implement the evaluation and management of multiple patients in the emergency department, including handling interruptions and task switching in order to provide optimal care
This is the first time that the Clinical Practice of EM has explicitly broken down multitasking into interruptions and task switching and this differentiation has been maintained in the 2013 update
Summary
Multitasking is a core skill in emergency medicine (EM). Emergency department (ED) work is by nature susceptible to interruptions due to time-critical tasks, patients arriving unpredictably in surges with undifferentiated problems with varying acuity. Universal problems like access block and ED overcrowding add to the multitasking duties of the EM physician. The ability to multitask does not come naturally to everyone, and often there is no formal curriculum to teach residents how to cope in the multitasking ED environment. Assuming that all residents will automatically assimilate and passively develop this skill during residency is flawed. There are multiple consequences of not recognizing and helping residents who struggle to cope within the multitasking environment - physician job stress, burnout [1], fatigue, and sleep deprivation [2,3,4]. Archana et al [5] described patient safety lapses due to gaps in information flow as a result of deficiencies in
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