The Functional Necessity of Interruption in Rapidly Changing, Unpredictable, and Demanding Task Environments

With Ben Swets, Post-Doctoral Researcher at SBU, and Peter Viccellio, Associate Chair of SBU's Department of Emergency Medicine.

The Emergency Room and similar environments are characterized by distribution of tasks and information across team members, probabilistic problem solutions, limited and variable access to resources, fluctuating priorities, and uncertainty in the nature, number, and timeline of tasks. The frequent interruptions observed in such settings have been traditionally viewed as harmful to performance. We conceptualize interruptions instead as providing critical and well-timed reminders to complete an unfinished task or to inform the doctor of ongoing shifts in case status. We are thus interested in the potential value of interruptions, with three aims: (a) to develop, through extensive direct observation of ER staff, a taxonomy of interruption types and how they affect performance, (b) to test the taxonomy's validity in an experimental setting using a simulation environment within which we can program features analogous to ER settings, and (c) to move toward policy and training to guide physicians and staff in sharing information and managing high cognitive demands.



Cognitive Processes Underlying Medical Diagnostic Errors

With Mark Graber, Chief of Medicine, Northport VA Medical Center and Ruthanna Gordon, currently at Illinois Institute of Technology.

Project funded by National Patient Safety Foundation.


Relevant Papers

Graber, M., Franklin, N., & Gordon, R. (2002). Reducing diagnostic errors in medicine: What's the goal? Academic Medicine, 77, 981-992.


Gordon, R. & Franklin, N. (2003). Cognitive underpinnings to Diagnostic Error: Reply to Croskerry. Academic Medicine, 78, 782.


Graber, M., Franklin, N., & Gordon, R. (2004). Diagnostic error in internal medicine. Archives of Internal Medicine, 165, 1493-1499.