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Blank brain images speak volumes about the pressures on pharmacists

Hannah Family, Marjorie Weiss and Jane Sutton explain how the use of blank brain images can determine the kind of pressures pharmacists feel under in their minds

By Hannah Family, Marjorie Weiss and Jane Sutton

Hannah Family, Marjorie Weiss and Jane Sutton explain how the use of blank brain images can determine the kind of pressures pharmacists feel under in their minds

Community pharmacists have been filling out “blank brains” (see illustration) and telling us what is most on their minds when they are at work. What have we learnt? There were no surprises that medicines use reviews and the new medicine service are top on the list of things that pharmacists think about. However, these images show that there are other concerns on these pharmacists’ minds that may not often be voiced: the professional isolation of being the only pharmacist in the dispensary and that voice in your head that asks “am I appreciated?”. Using images of the completed blank brains, we can show some of the work we are conducting into the mental workload and stresses pharmacists experience at work, and why it is just as important to ask what is on pharmacists’ minds when they are at work as it is to ask what or how much they are doing each day.

What is mental workload?

Mental workload is a measure of how much of our mental resources are being used when we carry out a task. It is important to measure because there are limits to how much our brains can think about or do at any given moment. When that limit is reached, we start to feel under pressure or start to be aware that we are trying to do too much at once. Importantly, it is known from other industries (eg, aerospace) that, at this limit, we are also more likely to make errors.

This idea that there is only so much one can do is not new. We all know there are limits to what we can feasibly achieve, the difficulty is we tend to focus on what we can physically achieve, and overlook what we can mentally achieve. This is probably because we forget that, when we are at work, we do not just think about the work or particular task we are doing at that moment in time. There is often a lot more going on in our brain than meets the eye until someone asks us to tell them what is on our mind.

The blank brain task

Over the past few months, we have been inviting community pharmacists to tell us what is on their minds by completing a blank template of the brain with all the things that they are thinking about. The picture shown is an example of the blank brains we have received (more can be seen at: This started off as just a fun competition as an aside to our research into the levels of mental workload community pharmacists experience. We never expected that these brains would provide us with such rich and detailed data on the pressures, worries and thoughts that might be playing on community pharmacists’ minds when they are at work. We are now working on ways of analysing the “brain data” so that we can publish our findings.

Capturing a moment

It is important to note that these images represent a point in time and, if we asked the same pharmacists to complete another blank brain, they would likely write and draw different things. These images are also unique to the individual and, although key tasks like medicines use reviews are a common theme for many of the entries we received, the personal concerns and experiences expressed will relate to some but not all community pharmacists. So we do not seek to generalise.

The same can be said for mental workload. The mental workload of a task will vary from person to person, day to day. This is because the amount of mental workload experienced while carrying out a task depends on the interaction between three key variables:

• The person (eg, personality, current mood state, expertise)
• The features of the task (eg, how complex it is, how much time is available to complete the task)
• The environment where the task is carried out (variations in noise, interruptions, temperature, amount of light, etc)

As we consider this definition of mental workload, the blank brain images take on a whole new meaning because now we can identify environmental features (interruptions, telephones), task characteristics (time pressure from waiting patients, targets to meet) and individual characteristics (mood, experience in the job, sore feet)that may affect the mental workload experienced by community pharmacists.

Why is it important

Failing to consider the mental workload of a task or the contributions that the individual, the environment and the task have on a person’s ability to carry out the task successfully could, in a pharmacy, lead to a fatal dispensing error being made. It is important to note that the amount of mental workload experienced by employees can often be out of their control if they are not given the licence to manage their working environment or how they carry out their work.

Mental workload

Since February 2012 we have been working with community pharmacists to find out more about the mental workload or mental stresses they experience at work. The main aim of this study is to measure in real time whether the mental workload that pharmacists experience while carrying out routine pharmacy tasks is related to dispensing errors.

To test this relationship, we have been inviting community pharmacists to take part in one of two studies which involve them carrying out a simulated final accuracy check on batches of dispensed items while we measure their mental states and other factors related to mental workload. We have been carrying out these simulated studies in our pharmacy practice suite at the University of Bath.
We are also carrying out a smaller field study with 10 community pharmacists to find out if the amount of mental workload pharmacists experience during our simulated tasks is higher or lower than when they are working in their own pharmacies.

Fill your own brain

If you would be interested in completing your own blank brain entry, visit for more information.


Project funding

This project was funded by the Pharmaceutical Trust for Educational and Charitable Objects as part of the funding stream “Community pharmacy: safe practice (working hours and conditions)”. The full study “The effects of mental workload on community pharmacists’ ability to detect dispensing errors” will be available in the new year. PTECO chairman Steve Churton commented: “I’m heartened to see such innovative use of PTECO funding and am impressed by the methods the researchers have used to connect with the profession. The issues of pharmacists’ workload and workplace pressures have always been important to me and I hope the outputs of this research will inform debate and policy development in this area. I await the final report with interest.”

ACKNOWLEDGEMENT This research would not have been possible without the support we have received from the Royal Pharmaceutical Society and the Great Western Local Pharmacy Forum.

Hannah Family is a psychologist with a background in experimental psychology and neuropsychology and is a final year doctoral student, Marjorie Weiss is a clinical pharmacist and professor of pharmacy practice and medicine use, and Jane Sutton is an occupational psychologist and lecturer in pharmacy practice, all at the University of Bath. Correspondence to: Hannah Family, Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA2 7AY

Citation: The Pharmaceutical Journal URI: 11110500

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Supplementary images

  • This “brain” entry was sent in by a community pharmacist, who said this is her brain at home

Supplementary information

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