title: Effect of distractions on operative performance and ability to multitask--a case for deliberate practice.
abstract: OBJECTIVE
  To measure the effect of distractions on the operative performance and analyze if practice and experience are the factors that can help to overcome the distractions.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Ten postgraduate year (PGY) 2-6 residents and two faculty members from Johns Hopkins' otolaryngology department were recruited and asked to deepen the dissection at the sinodural angle on the Voxel-man mastoidectomy simulator. They were asked to perform the task under four conditions: 1) no distractors, 2) differentiation and counting of a specific alarm sound among different sounds played in the background while performing the surgical task, 3) simultaneous performance of simple arithmetic task of moderate difficulty, and 4) simultaneous performance of the task with both sets of distractors combined.
  
  
  RESULTS
  Time taken for the task (P = .02) and error scores (P = .002) increased under the third and fourth conditions. The ability to multitask and response to surgical and cognitive tasks improved with increasing level of experience of the participants.
  
  
  CONCLUSIONS
  Distractions lead to impaired dexterity and an increase in the incidence of errors. However, experience and deliberate practice can help achieve the ability to multitask without compromising the operative performance.
authors: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
authors: Aadil
authors: A
authors: Ahmed
authors: Mueen
authors: M
authors: Ahmad
authors: C Matthew
authors: CM
authors: Stewart
authors: Howard W
authors: HW
authors: Francis
authors: Nasir I
authors: NI
authors: Bhatti
mesh_terms: D001288:Attention; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D007396:Internship and Residency; D008297:Male; D019300:Medical Errors; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education / Q000379:methods*; D011446:Prospective Studies; D013647:Task Performance and Analysis
keywords: Distraction; deliberate practice; dual-tasking; multitasking; otolaryngology; surgical education; surgical skills