Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments
Background: Diagnostic error is a major source of patient suffering. Research shows that physicians experience frequent interruptions while being engaged with patients and indicate that diagnostic accuracy may be impaired as a result. Since most studies in the field are observational, there is as ye...
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sg-ntu-dr.10356-1613572023-03-05T16:44:45Z Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments Alajaji, Mai Saleh, Nada AlKhulaif, Ali Hassan Mamede, Silvia Rotgans, Jerome Ingmar Sukkarieh, Hatouf AlHarbi, Nouf Magzoub, Mohi Eldin Schmidt, Henk G. Lee Kong Chian School of Medicine (LKCMedicine) Medical Education Research and Scholarship Unit Science::Medicine Diagnostic Error Cognition Background: Diagnostic error is a major source of patient suffering. Research shows that physicians experience frequent interruptions while being engaged with patients and indicate that diagnostic accuracy may be impaired as a result. Since most studies in the field are observational, there is as yet no evidence suggesting a direct causal link between being interrupted and diagnostic error. The experiments reported in this article were intended to assess this hypothesis. Methods: Three experiments were conducted to test the hypothesis that interruptions hurt diagnostic reasoning and increase time on task. In the first experiment (N=42), internal medicine residents, while diagnosing vignettes of actual clinical cases were interrupted halfway with a task unrelated to medicine, solving word-spotting puzzles and anagrams. In the second experiment (N=78), the interruptions were medically relevant ones. In the third experiment (N=30), we put additional time pressure on the participants. In all these experiments, a control group diagnosed the cases without interruption. Dependent variables were diagnostic accuracy and amount of time spent on the vignettes. Results: In none of the experiments interruptions were demonstrated to influence diagnostic accuracy. In Experiment 1: Mean of interrupted group was 0.88 (SD=0.37) versus non- interrupted group 0.91 (SD=0.32). In Experiment 2: Mean of interrupted group was 0.95 (SD=0.32) versus non-interrupted group 0.94 (SD=0.38). In Experiment 3: Mean of interrupted group was 0.42 (SD=0.12) versus non-interrupted group 0.37 (SD=0.08). Although interrupted residents in all experiments needed more time to complete the diagnostic task, only in Experiment 2, this effect was statistically significant. Conclusions: These three experiments, taken together, failed to demonstrate negative effects of interruptions on diagnostic reasoning. Perhaps physicians who are interrupted may still have sufficient cognitive resources available to recover from it most of the time. Published version 2022-08-29T05:56:47Z 2022-08-29T05:56:47Z 2022 Journal Article Alajaji, M., Saleh, N., AlKhulaif, A. H., Mamede, S., Rotgans, J. I., Sukkarieh, H., AlHarbi, N., Magzoub, M. E. & Schmidt, H. G. (2022). Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments. BMC Medical Education, 22(1), 182-. https://dx.doi.org/10.1186/s12909-022-03212-1 1472-6920 https://hdl.handle.net/10356/161357 10.1186/s12909-022-03212-1 35296302 2-s2.0-85126337104 1 22 182 en BMC Medical Education © The Author(s) 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. application/pdf |
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Science::Medicine Diagnostic Error Cognition Alajaji, Mai Saleh, Nada AlKhulaif, Ali Hassan Mamede, Silvia Rotgans, Jerome Ingmar Sukkarieh, Hatouf AlHarbi, Nouf Magzoub, Mohi Eldin Schmidt, Henk G. Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
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Background: Diagnostic error is a major source of patient suffering. Research shows that physicians experience frequent interruptions while being engaged with patients and indicate that diagnostic accuracy may be impaired as a result. Since most studies in the field are observational, there is as yet no evidence suggesting a direct causal link between being interrupted and diagnostic error. The experiments reported in this article were intended to assess this hypothesis. Methods: Three experiments were conducted to test the hypothesis that interruptions hurt diagnostic reasoning and increase time on task. In the first experiment (N=42), internal medicine residents, while diagnosing vignettes of actual clinical cases were interrupted halfway with a task unrelated to medicine, solving word-spotting puzzles and anagrams. In the second experiment (N=78), the interruptions were medically relevant ones. In the third experiment (N=30), we put additional time pressure on the participants. In all these experiments, a control group diagnosed the cases without interruption. Dependent variables were diagnostic accuracy and amount of time spent on the vignettes. Results: In none of the experiments interruptions were demonstrated to influence diagnostic accuracy. In Experiment 1: Mean of interrupted group was 0.88 (SD=0.37) versus non- interrupted group 0.91 (SD=0.32). In Experiment 2: Mean of interrupted group was 0.95 (SD=0.32) versus non-interrupted group 0.94 (SD=0.38). In Experiment 3: Mean of interrupted group was 0.42 (SD=0.12) versus non-interrupted group 0.37 (SD=0.08). Although interrupted residents in all experiments needed more time to complete the diagnostic task, only in Experiment 2, this effect was statistically significant. Conclusions: These three experiments, taken together, failed to demonstrate negative effects of interruptions on diagnostic reasoning. Perhaps physicians who are interrupted may still have sufficient cognitive resources available to recover from it most of the time. |
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Lee Kong Chian School of Medicine (LKCMedicine) |
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Lee Kong Chian School of Medicine (LKCMedicine) Alajaji, Mai Saleh, Nada AlKhulaif, Ali Hassan Mamede, Silvia Rotgans, Jerome Ingmar Sukkarieh, Hatouf AlHarbi, Nouf Magzoub, Mohi Eldin Schmidt, Henk G. |
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Article |
author |
Alajaji, Mai Saleh, Nada AlKhulaif, Ali Hassan Mamede, Silvia Rotgans, Jerome Ingmar Sukkarieh, Hatouf AlHarbi, Nouf Magzoub, Mohi Eldin Schmidt, Henk G. |
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Alajaji, Mai |
title |
Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
title_short |
Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
title_full |
Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
title_fullStr |
Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
title_full_unstemmed |
Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
title_sort |
failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments |
publishDate |
2022 |
url |
https://hdl.handle.net/10356/161357 |
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1759853917873635328 |