Beginning learners in medicine face a daunting challenge of utilizing information gained in the first two years of medical school in a clinical setting in the latter half of their medical school and into residency. Constant interruptions and lack of knowledge are but two of the factors that may hamper the early clinician’s ability to safely and efficiently care for patients. Thus, a system that organizes thought into specific compartments—compartmentalization may benefit the learner by separating tasks into smaller, more specific objectives to complete prior to moving on in the diagnostic algorithm. Developing a system that utilizes compartmentalization may ease the transition into clinical practice using simple and effective tools that allow the beginning physician to mitigate the invariable distractions and interruptions that occur daily to allow for the safe practice of medicine.
References
[1]
Archana, L., Forogh, H., Osman, R. S., Robert, A. G., Zhang, J. J., & Vimla, L. P. (2007). The Multitasking Clinician: Decision-Making and Cognitive Demand during and after Team Handoffs in Emergency Care. International Journal of Medical Informatics, 76, 801-811. https://doi.org/10.1016/j.ijmedinf.2006.09.019
[2]
Blair, R. (2012). 5 Steps of Compartmentalization: The Secret behind Successful Entrepreneurs.
https://www.forbes.com/sites/ryanblair/2012/06/26/5-steps-of-compartmentalization/#70dfaead1a62
[3]
Bragard, I., Dupuis, G., & Fleet, R. (2015). Quality of Work Life, Burnout, and Stress in Emergency Department Physicians: A Qualitative Review. European Journal of Emergency Medicine, 22, 227-234. https://doi.org/10.1097/MEJ.0000000000000194
[4]
Brown, D. (1995). Stress and Coping Strategies in Community Psychiatric Nurses: A Q-Methodological Study. Journal of Advanced Nursing, 21, 230-237.
https://doi.org/10.1111/j.1365-2648.1995.tb02519.x
[5]
Chi, M. T. H. (2006). Two Approaches to the Study of Experts’ Characteristics. In K. A. Ericsson (Ed.), The Cambridge Handbook of Expertise and Expert Performance (pp. 21-30). Cambridge: Cambridge University Press.
https://doi.org/10.1017/CBO9780511816796.002
[6]
Chisholm, C. D., Collison, E. K., Nelson, D. R., & Cordell, W. H. (2000). Emergency Department Workplace Interruptions: Are Emergency Physicians “Interrupt-Driven” and “Multitasking”? Academic Emergency Medicine, 7, 1239-1243.
https://doi.org/10.1111/j.1553-2712.2000.tb00469.x
[7]
Counselman, F. L., Babu, K., Edens, M. A., Gorgas, D. L., Hobgood, C., Marco, C. A. et al. (2017). The 2016 Model of the Clinical Practice of Emergency Medicine. Journal of Emergency Medicine, 52, 846-849. https://doi.org/10.1016/j.jemermed.2017.01.040
[8]
Croskerry, P. (2000). The Cognitive Imperative Thinking about How We Think. Academic Emergency Medicine, 7, 1223-1231.
https://doi.org/10.1111/j.1553-2712.2000.tb00467.x
[9]
Croskerry, P., & Sinclair, D. (2001). Emergency Medicine: A Practice Prone to Error? Canadian Journal of Emergency Medicine, 3, 271-276.
https://doi.org/10.1017/S1481803500005765
[10]
Duchscher, J. E. B. (2009). Transition Shock: The Initial Stage of Role Adaptation for Newly Graduated Registered Nurses. Journal of Advanced Nursing, 65, 1103-1113.
https://doi.org/10.1111/j.1365-2648.2008.04898.x
[11]
Ericsson, K. A. (2006). The Cambridge Handbook of Expertise and Expert Performance. Cambridge, NY: Cambridge University Press.
https://doi.org/10.1017/CBO9780511816796
[12]
Eva, K. W. (2005). What Every Teacher Needs to Know about Clinical Reasoning. Medical Education, 39, 98-106. https://doi.org/10.1111/j.1365-2929.2004.01972.x
[13]
Hymel, G., & Severyn, F. (1999). Typical Shiftwork Interruptions Faced by Supervising EM Faculty in an EM Residency Setting. Abstract Presented at: Society for Academic Emergency Medicine Midwest Regional Meeting, September, Ann Arbor, MI.
[14]
Jagsi, R., Weinstein, D. F., Shapiro, J., Kitch, B. T., Dorer, D., & Weissman, J. S. (2008). The Accreditation Council for Graduate Medical Education’s Limits on Residents’ Work Hours and Patient Safety. A Study of Resident Experiences and Perceptions before and after Hours Reductions. Archives of Internal Medicine, 168, 493-500.
https://doi.org/10.1001/archinternmed.2007.129
[15]
Kirmeyer, S. L. (1988). Coping with Competing Demands: Interruption and the Type A Pattern. Journal of Applied Psychology, 73, 621.
https://doi.org/10.1037/0021-9010.73.4.621
[16]
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (2000). To Err Is Human: Building a Safer Health System: A Report of The Committee on Quality of Health Care in America, Institute of Medicine. Washington DC: National Academy Press.
[17]
Michtalik, H. J., Yeh, H. C., Pronovost, P. J., & Brotman, D. J. (2013). Impact of Attending Physician Workload on Patient Care: A Survey of Hospitalists. JAMA Internal Medicine, 173, 375-377. https://doi.org/10.1001/jamainternmed.2013.1864
[18]
Miller, G. A. (1956). The Magical Number Seven, plus or minus Two: Some Limits on Our Capacity for Processing Information. Psychological Review, 63, 81.
https://doi.org/10.1037/h0043158
[19]
Rasmussen, J., & Jensen, A. (1974). Mental Procedures in Real-Life Tasks: A Case Study of Electronic Troubleshooting. Ergonomics, 17, 293-307.
https://doi.org/10.1080/00140137408931355
[20]
Rhodes, D. R., McFarland, K. F., Finch, W. H., & Johnson, A. O. (2001). Speaking and Interruptions during Primary Care Office Visits. Family Medicine, 33, 528-532.
[21]
Skaugset, L. M., Farrell, S., Carney, M., Wolff, M., Santen, S. A., Perry, M., & Cico, S. J. (2016). Can You Multitask? Evidence and Limitations of Task Switching and Multitasking in Emergency Medicine. Annals of Emergency Medicine, 68, 189-195.
https://doi.org/10.1016/j.annemergmed.2015.10.003
[22]
Tweed, M. J., Bagg, W., Child, S., Wilkinson, T. J., & Weller, J. M. (2010). How the Trainee Intern Year Can Ease the Transition from Undergraduate Education to Postgraduate Practice. The New Zealand Medical Journal (Online), 123, No. 1318.
[23]
Young, J. Q., Van Merrienboer, J., Durning, S., & Ten Cate, O. (2014). Cognitive Load Theory: Implications for Medical Education: AMEE Guide No. 86. Medical Teacher, 36, 371-384. https://doi.org/10.3109/0142159X.2014.889290
