By: Hope Shrader Sherman, PharmD and Meredith Howard, PharmD, BCPS
Pharmacists are frequently pulled in multiple directions: juggling phone calls, undertaking order verifications, and attempting to reach providers to clarify orders, all while counseling patients. Most pharmacists would agree that multitasking is an essential skill. While multitasking is reasonable for logistical-style tasks, it is much more challenging to perform cognitively demanding tasks while distracted, so much so that most people end up being less productive.1 This is especially true for pharmacy learners, many of whom are learning new topics or applying concepts for the first time. This productivity and focus further diminishes when switching between these tasks, resulting in “attention residue,” which has important implications when applied to the pharmacy education environment.
What is “attention residue?”
Attention residue is a concept first proposed by Sophie Leroy,2 which states that switching between cognitively demanding tasks causes the brain to retain focus on the previous task, making it difficult to focus and complete the new task. This was supported by a study in which undergraduate students were assigned to complete two tasks (task A and task B) in 5 minutes. Variables assessed in this study included task completion and time pressure, which was applied by having a visible time countdown in addition to emphasizing to the participants that the task was difficult to complete during the allotted time. Time pressure caused participants to rapidly complete task A before transitioning to task B. Results indicated that participants who had completed task A without time pressure, regardless of task completion, had poor performance on task B because they continued to ruminate on task A, however those who both completed the task while under time pressure exhibited less attention residue and improved performance on task B. This demonstrates that participants were better able to focus on the task at hand and perform better when the task was completed and time pressure was applied, because it helped them transition focus to the new task at hand (task B). Understanding attention residue and how to minimize it may be the key to optimizing efficiency and accuracy on cognitively demanding tasks.
Unfortunately, solutions to alleviate attention residue are not as simple as silencing email notifications or limiting back-to-back meetings. Having a clear deadline (time pressure) and working on tasks until completion must be implemented. Below we will describe strategies to minimize attention residue in different settings.
How does this apply to didactic teaching?
Due to the nature of didactic learning, it is not possible to avoid switching topics or eliminate attention residue entirely. Strategies to mitigate attention residue include modifying class schedules to facilitate lessons with similar disease states or organ systems on the same day rather than switching between multiple topics. Additionally, when transitioning to a new topic, consider introducing the upcoming topic, even if it is just the title or name of the disease state, before students take a break to allow them to start ruminating on the upcoming concepts.
When giving learners an assignment, it is important to provide learners with sufficient time to complete the task and establish time pressure. In a classroom, time pressure could be established by displaying a countdown timer for learners to see, frequent verbal reminders of time remaining, and emphasizing an assignment deadline prior to moving to the next topic.
How does this apply to precepting?
During rotations, it is more difficult to effectively establish time pressure. If a learner is deeply concentrating on a task, such as reviewing patient charts, set a clear timeline of when the task needs to be completed. In this setting, the goal should be to avoid interrupting the learner with questions or to-do items during cognitively demanding tasks, such as reviewing literature for a drug information question or developing patient recommendations, unless the interrupting item is time sensitive. For rotations where it may be challenging to have time dedicated for prolonged focus (ex: emergency medicine or community), consider blocking time for the learner to dedicate to these cognitively demanding tasks.
How does this apply to my time?
If your position requires you to work on multiple cognitively demanding tasks, it is believed to be more productive to work on one task until completion rather than attempting to shuffle between the tasks. Even checking your email or text prior to starting a task can result in ruminating over how you plan to respond, so it is best advised to silence notifications and avoid checking your inbox.
Attention residue is just one component of effectively performing deep, cognitively complex tasks in distracted environments, and may provide additional pieces to the growing puzzle known as cognitive load theory. “Deep Work” by Cal Newport3 reviews additional evidence-based strategies to improve productivity which may be impactful for faculty, pharmacists, and how we approach teaching our students.
How will you minimize attention residue in your learners?
References:
1. Rubinstein JS, Meyer DE & Evans JE. Executive Control of Cognitive Processes in Task Switching. Journal of Experimental Psychology: Human Perception and Performance. 2001;27:763-797. Doi: 10.1037//0096-1523.27.4.763
2. Leroy S. Why is it so hard to do my work? The challenge of attention residue when switching between work tasks. Organizational Behavior and Human Decision Processes. 2009;109(2):168-81. https://doi.org/10.1016/j.obhdp.2009.04.002
3. Newport C. Deep Work. Grand Central Publishing; 2016.
Author Bio(s):
Hope Shrader Sherman is a PGY-2 Ambulatory Care Pharmacy Resident at John Peter Smith Health Network and aAdjunct Assistant Professor at the University of North Texas Health Science Center. Educational scholarship interests include mindful teaching strategies and health equity. In her free time, Hope enjoys making pottery and baking.
Meredith Howard is an Adjunct Associate Professor of Pharmacotherapy at the University of North Texas Health Science Center College of Pharmacy. Her educational scholarship interests include experiential education, remediation, and faculty and preceptor development. In her free time, Meredith enjoys hiking, biking, and gardening.
Pulses is a scholarly blog supported by a team of pharmacy education scholars
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