Evidence map›Paper›PMID 35296302›Full record

ArticleBMC medical education2022

Failure to demonstrate effects of interruptions on diagnostic reasoning: three experiments.

Mai Alajaji, Nada Saleh, Ali Hassan AlKhulaif, Silvia Mamede, Jerome I Rotgans, Hatouf Sukkarieh, Nouf AlHarbi, Mohi Eldin Magzoub, Henk G Schmidt

Abstract read
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Article in BMC medical education, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mai AlajajiCollege of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Nada SalehCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ar Rimayah, Riyadh, 14611, Saudi Arabia.
Ali Hassan AlKhulaifEmergency Medicine Department, King Abdullah bin Abdulaziz University Hospital, Riyadh, 11564, Saudi Arabia.
Silvia MamedeErasmus University, Institute of Medical Education Research Rotterdam, Erasmus Medical Centre, and Department of Psychology, Erasmus University Rotterdam, Rotterdam, P.O. Box 1738, 3000, DR, The Netherlands.
Jerome I RotgansMedical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, 308232, Singapore.
Hatouf SukkariehCollege of Medicine, Alfaisal University, Takhassusi St, Riyadh, 11533, Saudi Arabia.
Nouf AlHarbiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ar Rimayah, Riyadh, 14611, Saudi Arabia.
Mohi Eldin MagzoubCollege of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
Henk G SchmidtDepartment of Psychology, Erasmus University Rotterdam, P.O. Box 1738, 3000, DR, Rotterdam, The Netherlands. schmidt@fsw.eur.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnostic error is a major source of patient suffering. Researchshows 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. Theexperiments reported in this article were intended to assess this hypothesis.

methodsThree 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.

resultsIn 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.

conclusionsThese 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.

Indexed as

PhysiciansDiagnostic ErrorsHumansCognitionDiagnostic errorEmergency medicineInternal medicine

Identifiers

PMID35296302
PMCPMC8925158

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.