Task Source Matters: Eye‐Tracking Evidence on Cognitive Load and Decision Accuracy in ICU Multitasking

ABSTRACT 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.