• Tom Keast, Annette E Forrest, Jamie W Sleigh, and Mary P LaPine.
• Critical Care Department, Waikato Hospital, Hamilton, New Zealand. tom.keast@nhs.net.
• Crit Care Resusc. 2015 Dec 1;17(4):274-9.

ObjectiveTo establish the role of distraction in learner performance and workload when ventilating a mannequin during a simulated cardiac arrest.Design, Setting And ParticipantsObservational, randomised simulation study of critical care doctors and nurses, set in the critical care department of Waikato Hospital, Hamilton, New ZealandInterventionsParticipants 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.Main Outcome MeasuresThe 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.ResultsWe 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.ConclusionsOur 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.

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