Emergency physicians epitomize what it's like to work in a time-pressured, interruption-based environment. Multitasking is necessary to survive in this environment where you are constantly shifting focus and addressing new tasks or problems as they arise.
EM residency programs focus a lot on teaching and evaluating medical knowledge, but how can they teach and evaluate residents in the equally important area of multitasking?
There exists a Multi-Tasking Assessment Tool (MTAT), developed to assess job performance of professionals working in a multitasking environment such as military personnel and pilots. This online tool gives the user three 5-minute multitasking tasks to complete.
Study In this prospective study, 35 EM residents from a single residency program took the MTAT test. Their scores were compared to an indirect marker of clinical work efficiency (average relative value units (RVU) per hour over a 6 month period). A high RVU suggests an efficient resident. The MTAT score correlation with RVUs were controlled for year in training and the in-service training exam score.
Year in training and MTAT score accounted for 68% of the variance seen in resident RVU efficiency. Of that 68% variance, year in training was far more correlative (87%) than the MTAT metrics (13%).
The in-service training exam score, as an indirect marker of medical knowledge, did not predict RVU efficiency.
MTAT scores did not differ significantly for the first, second, and third year residents.
What does this mean?
Although minor, MTAT scores may provide some predictive value in clinical work efficiency.
Lingering questions While it is a cool finding that MTAT scores may slightly predict RVUs for residents, this study brings up more questions:
Is RVU the best measure of efficiency?
Can high MTAT scores predict other things besides efficiency, such as how well residents might deal with the stress of interruptions and multitasking? Are emergency physicians with low MTAT scores more at risk for "burn out"?
How does one learn how to improve one's MTAT scores?
Is there a role for MTAT testing during medical school to help students in choosing their specialty?
Is there a role for MTAT testing for nursing students considering working in an ED?
An idea Access to the MTAT test unfortunately costs about $10 per test at www.multitaskingtests.com. Perhaps someone in EM should develop an open-access validated test to measure multitasking for EM residents and attendings.Hmm.
Reference Ledrick D, Fisher S, Thompson J, Sniadanko M. An Assessment of Emergency Medicine Residents’ Ability to Perform in a Multitasking Environment. Acad Med. 2009; 84:1289–1294.