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

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.