Modeling Task Scheduling Decisions of Emergency Department Physicians

Priority influences task selection decisions in multi-task management

The role of task priority on task selection in multi-task management is unclear based on prior work, leading to a common finding of 'priority neglect'. However, properties such as urgency and conflict may influence whether operators weigh priority in their decision. We examined the role of instructed task prioritization, bolstered by more urgent and conflicting conditions, on how operators select among emergent, concurrent tasks when multitasking. Using the Multi-Attribute Task Battery (MATB) multitasking platform we tested both an auditory communications task and a manual tracking task as the priority tasks. Results showed that instructed priority significantly increased target task selection under the conflicting task conditions for both tasks. Urgency itself may modulate whether instructions to prioritize affect task selection choices when multitasking, and therefore counter to prior results instructions may yet be useful for helping operators select a higher priority task under conflict, a generalizable effect to be further explored.

Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies

Background

Multitasking is a key skill for emergency department (ED) providers. Yet, potentially beneficial or debilitating effects for provider functioning and cognition are underexplored. We therefore aimed to investigate the role of multitasking for ED physicians’ work stress and situation awareness (SA).

Methods

Two consecutive, multi-source studies utilizing standardized expert observations in combination with physicians’ self-reports on stress and SA were set out in an academic ED. To control for ED workload, measures of patient acuity, patient counts, and ED staff on duty were included. Regression analyses estimated associations between observed proportion of time spent in multitasking with matched ED physicians’ reports on stress (study 1) and SA (study 2).

Results

ED physicians engaged between 18.7% (study 1) and 13.0% (study 2) of their worktime in multitasking. Self-reported as well as expert-observed multitasking were significantly associated. This confirms the internal validity of our observational approach. After controlling for ED workload, we found that physicians who engaged more frequently in multitasking perceived higher work stress (Beta = .02, 95%CI .001–.03; p = .01). In study 2, ED physicians with more frequent multitasking behaviors reported higher SA (B = .08, 95%CI .02–.14; p = .009).

Conclusions

Multitasking is often unavoidable in ED care. Our findings suggest that ED physicians’ multitasking increases stress experiences, yet, may facilitate professional’s experiences of situation awareness. Our results warrant further investigation into potentially ambivalent effects of ED providers’ multitasking in effectively sharing time between competing demands while maintaining performance and safety.