Skip Navigation LinksHome > November 17, 2011 - Volume 33 - Issue 11 > Screened & Examined: Multi … Must Check Email! … Tasking
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Emergency Medicine News:
doi: 10.1097/01.EEM.0000408455.22901.85
Screened & Examined

Screened & Examined: Multi … Must Check Email! … Tasking

Ballard, Dustin MD

Free Access

I'm sitting down to write on an important topic. I should check my email. Right, where was I? An important topic for students, parents, professionals, and, well, just about everyone. Who's texting me? Oh, shoot; I need to finish that Amazon order. I forgot to call the plumber. And the dog needs to go out. Did I feed my daughter's Brazilian water frog? I should check my email. Wait. Focus. Important topic. Interesting topic. And it's critical that everyone understand the limitations and risks associated with it. I really should check my email. Multi … must check email! … tasking.

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Like many people in our digitalized and sensory-loaded world, I'm a fervent multitasker. Email, bills, scheduling, patient care, child care, pet care, Twitter care, fantasy sports; I can do it all. And I can do it all at the same time! At least so I thought. Just checked my email for the fourth time this paragraph. My wife wants to know if we can go to a school fundraiser tonight. My boss is trying to schedule a tennis match. I wonder which QBs are available on the CBS Sportsline waiver wire? Expedia has a new fare alert for me. $299 to fly to Omaha! Sweet. Contrary to the ethos I've prided myself on, in a world of information overload, constant data processing can actually “smog,” “asphyxiate,” and starve away productive time. In fact, multitasking may threaten efficiency more than aid it.

Skeptical? Well, stay with me here (your stock portfolio and Facebook newsfeed can wait), and consider evidence from cognitive testing. Researchers looking at individuals performing two or more tasks at once have found that, quite consistently, people complete tasks faster if they do them serially (one, then the next) rather than in parallel (start one, start the other, back to the first, and so on). In fact, loss of efficiency has been estimated to be around half-a-second per task-switch and up to twice the sum of the time needed to complete two tasks in order. So, for example, if it takes me two minutes to check and respond to my email and three minutes to order a new mattress online, it would take me up to 10 minutes to do the two tasks “at the same time” (switching back and forth between tasks with a delay for each switch). But if I did the tasks serially (focusing on one task and completing it before moving on to the next), the two tasks should take me only five minutes.

As we all know, multitasking is more or less a fact of life. We are forced to multitask some or all of the time, at work and at home. A busy shift in the emergency department is an excellent example of this, one with which we are all quite familiar. We spend our days talking with patients, performing physical exams, entering orders, documenting, calling consultants, communicating with nursing and other personnel, performing procedures, and making referrals, all while trying not to neglect an important task like prescribing the correct medication. Studies have shown that emergency physicians are interrupted four to 14 times per hour, or every four minutes or so. An observational study reported that ED nurses (at work) multitask 34 percent of the time. Each and every single one of the interruptions that ED providers experience could have disastrous consequences. (This is why we have developed safety mechanisms like timeouts and checklists.)

But, of course, some multitasking is unavoidable. Our patients surely appreciate that we break away from a routine task, like charting, to tackle another more critical task, such as providing acute resuscitation. And, keep in mind that some multitasking is not harmful. For some people, listening to music while driving or studying is not really multitasking at all but rather a multisensory approach to a task. This habit may or may not affect efficiency and performance. People are (according to cognitive studies) able to train themselves to block out distractions when performing an assignment. Note that I say “distractions,” not tasks. Tasks, especially ones that require working memory — very short-term memory designed to aid in completion of short-term tasks — will be more efficiently completed in order and cannot be blocked out as part of a multisensory approach. Working memory is ephemeral and highly sensitive to interruptions. We all experience this as those I-lost-my-train-of-thought moments.

Can you minimize brain stalls and achieve a healthy level of multitasking? Maybe, but first you have to set aside dedicated time to think, focus, and plan. Creativity benefits from focus, and people who have planned or rehearsed tasks beforehand are less likely to suffer delays. Here's another tip: try to resist overdosing on jolts of satisfaction (“dopamine squirts”) associated with compulsive behavior, like checking email every 2.4 minutes. And when possible, finish what you started — NOW — rather than deferring it to the “later” bucket. Working memory is temporary, and what may seem unforgettable right now is actually quite forgettable in 15 minutes.

Finally, experiment with focus adjuncts: meditation or paying attention to your breathing may help, as might noise-erasing headphones (which, my wife lovingly has dubbed “wife- and kid-erasers”). Of course, a lot of the modern world cannot be easily “noise-erased,” but if you make an effort to slow down, especially with important endeavors, your reward, ultimately, will be higher efficiency and fewer mistakes.

Phew, I've made it through this task. Hope you did, too. How many unread emails do I have? That frog must be absolutely starving. Now, if you'll excuse me, I've got a few other things to do.

Comments about this article? Write to EMN at emn@lww.com.

Dr. Ballard is an associate emergency physician at Kaiser-Permanente in San Rafael, CA, and the chair of the CREST ED Research Network. His writing credits include co-authorship with Angela Ballard of the award-winning travel narrative A Blistered Kind of Love: One Couple's Trial by Trail (Mountaineers Books, 2003) and authorship of The Bullet's Yaw (IUniverse, 2007). Dr. Ballard writes a biweekly-medical column for the Marin Independent Journal, which he posts on his blog: http://incisionanddrainage.blogspot.com.

© 2011 Lippincott Williams & Wilkins, Inc.

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