Multitasking behaviors and provider outcomes in emergency department physicians: two consecutive, observational and multi-source studies.

BACKGROUND: Multitasking is a key skill for emergency department (ED) providers. Yet, potentially beneficial or debilitating effects for provider functioning and cognition are underexplored. We therefore aimed to investigate the role of multitasking for ED physicians' work stress and situation awareness (SA). METHODS: Two consecutive, multi-source studies utilizing standardized expert observations in combination with physicians' self-reports on stress and SA were set out in an academic ED. To control for ED workload, measures of patient acuity, patient counts, and ED staff on duty were included. Regression analyses estimated associations between observed proportion of time spent in multitasking with matched ED physicians' reports on stress (study 1) and SA (study 2). RESULTS: ED physicians engaged between 18.7% (study 1) and 13.0% (study 2) of their worktime in multitasking. Self-reported as well as expert-observed multitasking were significantly associated. This confirms the internal validity of our observational approach. After controlling for ED workload, we found that physicians who engaged more frequently in multitasking perceived higher work stress (Beta = .02, 95%CI .001-.03; p = .01). In study 2, ED physicians with more frequent multitasking behaviors reported higher SA (B = .08, 95%CI .02-.14; p = .009). CONCLUSIONS: Multitasking is often unavoidable in ED care. Our findings suggest that ED physicians' multitasking increases stress experiences, yet, may facilitate professional's experiences of situation awareness. Our results warrant further investigation into potentially ambivalent effects of ED providers' multitasking in effectively sharing time between competing demands while maintaining performance and safety.

Aerobic biodegradation of cis-1,2-dichloroethene as sole carbon source: Stable carbon isotope fractionation and growth characteristics.

Cis-1,2-dichloroethene (cDCE) is a compound of concern at many chloroethene-contaminated sites, since it tends to accumulate during reductive dechlorination of the higher chlorinated ethenes. Stable carbon isotope fractionation during aerobic cDCE biodegradation was observed in groundwater microcosms under varying incubation conditions (room temperature/groundwater temperature; with/without inorganic nutrients), and resulted in an average stable carbon isotope enrichment factor of -15.2+/-0.5 per thousand. A new enrichment culture, obtained from groundwater microcosms, degraded cDCE concentrations up to 100mgL(-1), was active at temperatures between 4 and 23 degrees C, had a pH optimum of approximately 7, and could withstand prolonged periods (250d) of starvation. Microbial growth during degradation of cDCE as sole carbon and energy source was demonstrated by protein formation in mineral medium not containing any known auxiliary substrate. The obtained growth yield was 12.5+/-1.9g of proteinMol(-1) of cDCE, with a doubling time of 53+/-2h at 23 degrees C. Aerobic degradation of cDCE as sole carbon and energy source appears to be a promising biological process for site remediation.