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The ability to pay good attention allows us to be focussed, to apply our concentration to the task at hand while being able to manage other distractions.

Which all sounds fine in theory; how to actually manage our distractions in an era when they are constantly bombarding us, isn’t always so easy.

One of the examples I have often heard quoted about people best equipped to be focussed includes brain surgeons – along the lines of “a brain surgeon can’t afford to make a mistake so has highly developed attention skills”.

Well, as you may well know, to get good at something you have to practice first.

Which may also tell you something else. Brain surgeons aren’t necessarily born with good focus.

A study from Oregon University has examined the number of mistakes made by inexperienced surgeons when they were subjected to distractions while undertaking a cholecystectomy (removal of the gall bladder).

If you are of a nervous disposition or have gall bladder disease, you may choose not to read on…

Now this was a simulation, the surgeon’s weren’t actually doing a real operation. Phew!

The surgeons being studied were qualified aged 27 to 35 years old and in their second, third and research year of residency. So they already would have had some amount of experience. They were undertaking the procedure using a laparoscope, which requires considerable skill and concentration.

The distractions included cell phones ringing, a metal tray clanging to the floor, others in the theatre asking the surgeon questions about problems that had occurred with a previous surgical patient (deemed a necessary conversation) and another person deciding this was a great time to start discussing politics (deemed an unnecessary conversation but quite likely to occur).

The results?

Well perhaps it should come as no surprise but these young highly intelligent surgeon showed that they were just as fallible to the disruptive effect of distractions as anyone else – which could be of considerable concern when a highly complex and potentially risky procedure is being undertaken.

Of the group of 18, 8 made serious errors, especially if they were operating in the afternoon. This equates to 44% of the group.

As a comparison when not distracted, only one surgeon in the group made one mistake.

The researchers are now trying to work out ways to minimise the impact of distractions in the operating room. As they noted, humans are fallible. We can all make mistakes, but some instances are going to increase that happening and if this is at a time where a mistake could prove costly or damaging to a patient, clearly identifying how to minimise these from occurring is very important.

In looking at some of the factors from this study what else can be gleaned for further evaluation?

Firstly these were young surgeons and relatively inexperienced. The findings have been presented to audiences of older more experienced surgeons who appeared little surprised by the findings – presumably they are thinking along the lines that the more times you practice a procedure, the better you become at doing it and better able to cope with distractions.

It’s a bit like driving. When first learning to drive it takes an enormous amount of mental energy and concentration to get it all to happen and any distraction can have a fairly major impact on our skill. Once you have learnt the skill and embedded it as a learned habit, it becomes automated, freeing up the prefrontal cortex to have more space to pay attention to other things in our environment.

The researchers noted that the surgeons made more errors in the afternoon despite the fact that “conventional” fatigue was not a factor. Yes more mistakes will be made when we are tired, but here looking at the brain’s perspective it is important to consider that we are not designed to pay focussed attention for long periods of time. Mental fatigue sets in and the prefrontal lobes being a very energy hungry part of the brain attempts to minimise cognitive cost by interjecting their own energy saving measures with mind wandering.

Should we be surprised more errors occurred in the afternoon? I don’t think so. The brain has energy constraints as mentioned and we all have our productive zone, that precious 2-3 hours each day when we work at our best, are mentally refreshed, energetic and able to manage our distractions.

If the surgeon has already had a busy morning making decisions, planning, organising

and exerting willpower in choosing when to do or not do certain things, then cognition is definitely going to be more susceptible to distraction.

That’s why making those really important decisions are best not being made late inthe afternoon. The brain may well have run out of grade “A” thinking power.

Other studies have looked into this and discovered happily that willpower whilst limited and rapidly depleted, can be restored with a sweet of drink of lemonade.

What would be interesting would be for the researchers to repeat this type of study and use the lemonade drink to see if that helped to reduce afternoon errors.

So which distractions were the worst?

Those interrupting questions caused the most problems, followed by the sidebar conversations around politics.

And the moral of the story is?

  • We are all impacted by distractions.
  • Younger less experienced operators requiring greater focus (especially while learning) appear more susceptible to distractions.
  • Different types of distractions will have different impact on performance
  • It is important to consider “how” to reduce environmental distractions and also to remember our brain especially the prefrontal cortex, is energy hungry with limited capacity and requires frequent brain breaks in order to work at it’s best.

How do you manage your distractions at work?


Robin L. Feuerbacher, Kenneth H. Funk, Donn H. Spight, Brian S. Diggs, John G. Hunter. Realistic Distractions and Interruptions That Impair Simulated Surgical Performance by Novice SurgeonsORDIs Impair Simulated Surgical Performance. Archives of Surgery, 2012; : 1 DOI: 10.1001/archsurg.2012.1480

Dr Jenny Brockis

Dr Jenny Brockis is a medical practitioner and internationally board-certified lifestyle medicine physician, workplace health and wellbeing consultant, keynote speaker and best-selling author. You can now pre-order her new book ‘The Natural Advantage’ due for publication in October 2024.

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