title: Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.
abstract: BACKGROUND
  Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance.
  
  
  OBJECTIVE
  The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance.
  
  
  METHODS
  A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated.
  
  
  RESULTS
  About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098).
  
  
  CONCLUSIONS
  Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.
authors.affiliation: Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, University Hospital, Munich, Germany. matthias.weigl@med.lmu.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Weigl
authors.forename: Andreas
authors.initials: A
authors.lastname: Müller
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.forename: Peter
authors.initials: P
authors.lastname: Angerer
mesh_terms: D000328:Adult; D004526:Efficiency; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011787:Quality of Health Care; D013315:Stress, Psychological; D013647:Task Performance and Analysis; D016526:Workload