Related Experiment Video
Updated: Mar 28, 2026
Eye Tracking During A Complex Aviation Task For Insights Into Information Processing
Published on: April 4, 2025
The effect of a standardised source of divided attention in airway management: A randomised, crossover,
Johannes Prottengeier1, Marlen Petzoldt, Nikola Jess
1From the Department of Anaesthesiology (JP, MP, NJ, AM, JS, GB), and Department of Medical Informatics, Biometry and Epidemiology, Erlangen University Hospital, Erlangen, Germany (CG).
Background:
Dual-tasking, the need to divide attention between concurrent tasks, causes a severe increase in workload in emergency situations and yet there is no standardised training simulation scenario for this key difficulty.
Objectives:
We introduced and validated a quantifiable source of divided attention and investigated its effects on performance and workload in airway management.
Design:
A randomised, crossover, interventional simulation study.
Setting:
Center for Training and Simulation, Department of Anaesthesiology, Erlangen University Hospital, Germany.
Participants:
One hundred and fifty volunteer medical students, paramedics and anaesthesiologists of all levels of training.
Interventions:
Participants secured the airway of a manikin using a supraglottic airway, conventional endotracheal intubation and video-assisted endotracheal intubation with and without the Paced Auditory Serial Addition Test (PASAT), which served as a quantifiable source of divided attention.
Main Outcome Measures:
Primary endpoint was the time for the completion of each airway task. Secondary endpoints were the number of procedural mistakes made and the perceived workload as measured by the National Aeronautics and Space Administration's task load index (NASA-TLX). This is a six-dimensional questionnaire, which assesses the perception of demands, performance and frustration with respect to a task on a scale of 0 to 100.
Results:
All 150 participants completed the tests. Volunteers perceived our test to be challenging (99%) and the experience of stress and distraction true to an emergency situation (80%), but still fair (98%) and entertaining (95%). The negative effects of divided attention were reproducible in participants of all levels of expertise. Time consumption and perceived workload increased and almost half the participants make procedural mistakes under divided attention. The supraglottic airway technique was least affected by divided attention.
Conclusion:
The scenario was effective for simulation training involving divided attention in acute care medicine. The significant effects on performance and perceived workload demonstrate the validity of the model, which was also characterised by high acceptability, technical simplicity and a novel degree of standardisation.
Related Concept Videos
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
01:15Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...