Assessing emergency department physician workload: A NASA-TLX analysis by experience and care type

Area of Science:

• Emergency Medicine
• Occupational Health
• Human Factors Engineering

Background:

• Emergency departments (EDs) have high physician cognitive and physical demands.
• Limited data exist on ED physician workload for staffing and operational decisions.

Purpose of the Study:

• Quantify perceived workload across ED tasks using NASA Task Load Index (NASA-TLX).
• Examine workload variations by physician experience, patient acuity, and clinical context.
• Generate insights for resource allocation and task distribution in EDs.

Main Methods:

• Observational survey of 60 ED physicians (interns, residents, specialists) at a tertiary hospital.
• NASA-TLX questionnaires assessed workload for procedures and patient-care tasks.
• Analyses stratified by physician experience, Korean Triage and Acuity Scale (KTAS) level, and chief complaint.

Main Results:

• Interns reported highest workload for complex procedures (e.g., thoracentesis, lumbar puncture).
• Resident workload decreased postgraduate years 1-3, then increased in year 4 due to supervision.
• High patient acuity (KTAS 1-2) and neurological complaints correlated with higher workload across all levels.

Conclusions:

• Perceived ED physician workload is significantly influenced by task type, experience, and patient acuity.
• Findings support evidence-based staffing, workload redistribution, and training strategies.
• Optimizing physician performance and mitigating cognitive overload in resource-limited EDs is achievable.