Need for recovery amongst emergency physicians in the UK and Ireland: A cross-sectional survey

OBJECTIVES: To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores. DESIGN: Cross-sectional electronic survey. SETTING: Emergency departments (EDs) (n=112) in the UK and Ireland. PARTICIPANTS: Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019. MAIN OUTCOME MEASURE: NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery. RESULTS: The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5-90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%-50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%-75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%-100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9). CONCLUSION: Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible

Incidental Learning in Human Performance

The fact that subjects will learn even when they are not explicitly instructed to do so has been repeatedly demonstrated. This phenomenon has been termed incidental learning, and is defined as "learning which apparently takes place without a specific motive or a specific formal instruction and set to learn the activity or material in question." (McGeoch and Iron, 1952; p. 120). In both "intentional" and "incidental" learning, the subjects' receptors must be stimulated; he must see or hear the stimulus material. The main difference is one of set. "Incidentalness" refers to the absence of an experimentally induced set to learn. The work "apparently" has been included in the definition because experimental findings (e.g. Postmand and Senders, 1946) have indicated that incidental learning, when it does occur, is frequently the result of self-instructed sets generalized from other learning situations. For the purposes of this review therefore, incidental learning will be defined as learning which occurs in the absence of (a) experimentally administered instructions to learn, and (b) introspectively reported intention to learn