Journal of advanced nursing · 2026
Task Source Matters: Eye-Tracking Evidence on Cognitive Load and Decision Accuracy in ICU Multitasking.
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Ge Hui, Li Jiashuai, Feng Tingting, Hu Huiling, Yuan Cui, Wu Xue
Аннотация
AIM: To examine how task source and disease severity influence cognitive workload and decision-making performance among intensive care unit nurses during concurrent multitasking. Understanding how different clinical information sources influence nurses' decision-making may provide insights for supporting decision-making in complex critical care environments.
DESIGN: A laboratory-based 2 × 2 mixed-design experimental study.
METHODS: Thirty ICU nurses participated in a concurrent task prioritization task in which task source (machine-induced vs. human-induced) and disease severity (high vs. low) were manipulated. Eye-tracking measures, including fixation, saccade, blink, and pupil diameter metrics, together with decision accuracy, were collected during 80 task trials per participant.
RESULTS: Decision accuracy was significantly higher for machine-induced tasks than for human-induced tasks and was also higher under high-severity conditions than under low-severity conditions. Significant main effects of task source were observed across multiple eye-tracking measures. Compared with human-induced tasks, machine-induced tasks were associated with higher cognitive workload, reflected by increased total fixation duration, fixation count, saccade count, and pupil diameter. Disease severity significantly affected several eye-tracking measures; however, these effects were mainly observed during human-induced tasks, with no significant severity-related differences during machine-induced tasks.
CONCLUSION: Task source and disease severity influence cognitive processing patterns during ICU multitasking. Higher cognitive workload does not necessarily impair clinical decision accuracy, and task-related information characteristics play a critical role in shaping decision-making performance.
IMPLICATIONS FOR THE PROFESSION: The findings highlight the need for nursing practice to consider how different sources of task demands shape cognitive processing during multitasking. Recognizing that higher cognitive workload may support accurate decision-making under certain information conditions can inform task prioritization, clinical training, and the cognition-sensitive decision support for ICU nurses.
IMPACT: This work advances evidence-based understanding of cognitive workload and decision-making in intensive care nursing.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
DESIGN: A laboratory-based 2 × 2 mixed-design experimental study.
METHODS: Thirty ICU nurses participated in a concurrent task prioritization task in which task source (machine-induced vs. human-induced) and disease severity (high vs. low) were manipulated. Eye-tracking measures, including fixation, saccade, blink, and pupil diameter metrics, together with decision accuracy, were collected during 80 task trials per participant.
RESULTS: Decision accuracy was significantly higher for machine-induced tasks than for human-induced tasks and was also higher under high-severity conditions than under low-severity conditions. Significant main effects of task source were observed across multiple eye-tracking measures. Compared with human-induced tasks, machine-induced tasks were associated with higher cognitive workload, reflected by increased total fixation duration, fixation count, saccade count, and pupil diameter. Disease severity significantly affected several eye-tracking measures; however, these effects were mainly observed during human-induced tasks, with no significant severity-related differences during machine-induced tasks.
CONCLUSION: Task source and disease severity influence cognitive processing patterns during ICU multitasking. Higher cognitive workload does not necessarily impair clinical decision accuracy, and task-related information characteristics play a critical role in shaping decision-making performance.
IMPLICATIONS FOR THE PROFESSION: The findings highlight the need for nursing practice to consider how different sources of task demands shape cognitive processing during multitasking. Recognizing that higher cognitive workload may support accurate decision-making under certain information conditions can inform task prioritization, clinical training, and the cognition-sensitive decision support for ICU nurses.
IMPACT: This work advances evidence-based understanding of cognitive workload and decision-making in intensive care nursing.
PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.