Rattima SirihorachaiMichelle L. AebersoldNadine B. SarterMarcelline HarrisValarie MarshRichard W. RedmanUniversity of Michigan School of NursingUniversity of Michigan, Ann ArborMahidol University2019-08-232019-08-232018-11-01Clinical Simulation in Nursing. Vol.24, (2018), 14-24187613992-s2.0-85055093976https://repository.li.mahidol.ac.th/handle/20.500.14594/46096© 2018 International Nursing Association for Clinical Simulation and Learning Background: Several patient safety organizations have acknowledged that interruptions may be a contributing factor in medical error. Studies examining individual cognitive reactions to interruptions are lacking, which hinders the development of effective interventions to reduce interruptions. Methods: A mixed-methods study was conducted including observations (n = 15), participation in high-fidelity simulations (n = 30), and debriefing interviews with participants after completion of the simulation exercise. Results: Experienced nurses more frequently violated policy in terms of allowing interrupting events to continue during time-out procedures (p <.003). Results from debriefing interviews indicated that participants used two cognitive strategies to manage distractions and interruptions. Conclusions: This study showed that there were frequent distractions and interruptions during critical tasks in the operating room. It also supports the use of high-fidelity simulation as a tool to examine circulating nurses' decision-making in management of distractions.Mahidol UniversityMathematicsNursingSocial SciencesArticleSCOPUS10.1016/j.ecns.2018.08.004