Multitasking simulation: Present application and future directions

Abstract

The Accreditation Council for Graduate Medical Education lists multi-tasking as a core competency in several medical specialties due to increasing demands on providers to manage the care of multiple patients simultaneously. Trainees often learn multitasking on the job without any formal curriculum, leading to high error rates. Multitasking simulation training has demonstrated success in reducing error rates among trainees. Studies of multitasking simulation demonstrate that this type of simulation is feasible, does not hinder the acquisition of procedural skill, and leads to better performance during subsequent periods of multitasking. Although some healthcare agencies have discouraged multitasking due to higher error rates among multitasking providers, it cannot be eliminated entirely in settings such as the emergency department in which providers care for more than one patient simultaneously. Simulation can help trainees to identify situations in which multitasking is inappropriate, while preparing them for situations in which multitasking is inevitable.

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

“…Although multitasking is considered a key skill for health care professionals, systematic training and formal developmental approaches that address task switching behaviors with respect to the possible negative effects of multitasking are still in their early stages. In ED practice, several avenues to address and teach the benefits and pitfalls of multitasking are feasible at different system levels: this may include on an individual level deliberate reflections on error-prone or inefficient work practices, accumulated experiences of safety-critical demands, and development of personal biases; on team-level, simulation approaches with post-hoc debriefings, senior supervision, crew-resource-management, delegation of duties, use of decision support tools; on an organizational level, provision of adequate resources, role-modeling by superiors, and implementation of technological support systems [ 3 , 10 , 12 , 13 , 55 , 59 ]. Since multitasking is unavoidable in acute medical work, comprehensive and system-wide approaches are necessary that are cognizant of the complex tradeoffs of multitasking behaviors for safe management of multiple and often competing care demands.…”

Final-year medical students’ self-assessment of facets of competence for beginning residents

“…They lead to full integration of all health system-related competences needed in medical education for graduates to provide for comprehensive patient care [ 38 ]. Multitasking simulations can help medical trainees learn how to handle demanding management tasks and potentially reduce the stress accompanying work planning and prioritizing [ 39 ]. However, special training for such health system-related competences could also be included at the beginning of postgraduate training [ 40 ].…”

Perceived strain of undergraduate medical students during a simulated first day of residency

“…The more time physicians spent on multitasking the higher is the level of the strain they perceive [25]. Since multitasking can be necessary in many clinical situations and leads to higher failure rates, multitasking simulations might help undergraduate and postgraduate students to cope with such difficult situations [26]. Being familiar with multitasking situations after a simulation might also be helpful to reduce strain.…”