title: A randomised study of the effect of external distractors on the quality of ventilation in a simulated adult cardiac arrest.
abstract: OBJECTIVE
  To establish the role of distraction in learner performance and workload when ventilating a mannequin during a simulated cardiac arrest.
  
  
  METHODS
  Observational, randomised simulation study of critical care doctors and nurses, set in the critical care department of Waikato Hospital, Hamilton, New Zealand
  
  
  METHODS
  Participants ventilated a mannequin for 1 minute in a neutral scenario that acted as a control, before immediately continuing to ventilate the mannequin in two experimental scenarios for 2 minutes each. Scenarios included one in which participants were asked questions based on resuscitation algorithms, and one in which the participants had to play the children's game hangman. The order of the experimental scenarios was randomised.
  
  
  METHODS
  The primary clinical performance measure was ventilatory rate. Secondary performance measures of peak airway and mean airway pressures were also analysed. Individual workload was assessed using a questionnaire based on the National Aeronautics and Space Administration task load index.
  
  
  RESULTS
  We found no significant difference in any performance variable between the three scenarios. Workload was significantly lower in the control scenario. We found no difference in workload between the clinical and hangman scenarios. Doctors and nurses performed equally. Randomisation group had no effect on performance.
  
  
  CONCLUSIONS
  Our study suggests that simple distractors have a potent effect on perceived clinician workload, even when performing the most simple of tasks, but may not strongly influence the objective performance of the task.
authors.affiliation: Critical Care Department, Waikato Hospital, Hamilton, New Zealand. tom.keast@nhs.net.
authors.forename: Tom
authors.initials: T
authors.lastname: Keast
authors.affiliation: Critical Care Department, Waikato Hospital, Hamilton, New Zealand.
authors.forename: Annette E
authors.initials: AE
authors.lastname: Forrest
authors.affiliation: Critical Care Department, Waikato Hospital, Hamilton, New Zealand.
authors.forename: Jamie W
authors.initials: JW
authors.lastname: Sleigh
authors.affiliation: Critical Care Department, Waikato Hospital, Hamilton, New Zealand.
authors.forename: Mary P
authors.initials: MP
authors.lastname: LaPine
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000592:standards / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003422:Critical Care / Q000592:standards / Q000706:statistics & numerical data; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008348:Manikins; D009520:New Zealand; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data*