Improving our understanding of multi-tasking in healthcare: Drawing together the cognitive psychology and healthcare literature

•Multi-tasking can have detrimental effects on task performance and increase errors.•Multi-tasking is ubiquitous in healthcare and poses a risk to patient safety.•Evidence about multi-tasking from psychology and healthcare literature was compared.•A framework to advance the measurement of multi-tasking in healthcare is proposed.•Findings will guide investigations of multi-tasking in healthcare.

Multi-tasking is an important skill for clinical work which has received limited research attention. Its impacts on clinical work are poorly understood. In contrast, there is substantial multi-tasking research in cognitive psychology, driver distraction, and human-computer interaction. This review synthesises evidence of the extent and impacts of multi-tasking on efficiency and task performance from health and non-healthcare literature, to compare and contrast approaches, identify implications for clinical work, and to develop an evidence-informed framework for guiding the measurement of multi-tasking in future healthcare studies. The results showed healthcare studies using direct observation have focused on descriptive studies to quantify concurrent multi-tasking and its frequency in different contexts, with limited study of impact. In comparison, non-healthcare studies have applied predominantly experimental and simulation designs, focusing on interleaved and concurrent multi-tasking, and testing theories of the mechanisms by which multi-tasking impacts task efficiency and performance. We propose a framework to guide the measurement of multi-tasking in clinical settings that draws together lessons from these siloed research efforts.