A Trial of a Video Game Intervention to Recalibrate Physician Heuristics

NCT02857348 | Completed

• 1 other identifier: PRO16070572
• Study Type: interventional
• Target: 368
• Locations: 0 countries
• Sites: N/A

Brief Summary

The objective of this study is to compare the efficacy of a video game designed to recalibrate physician heuristics in trauma triage with a standard educational program.

Conditions

Wounds and Injuries

Keywords

decision making; heuristics

Outcome Measures

Primary Outcomes (1)

• Under-triage rate

  Physicians in both arms of the study will be randomized to complete one of two versions of a virtual simulation: a control version and a cognitive load version. They will complete the simulation upon completion of the intervention, ideally within one month of enrollment. The virtual simulation replicates the environment of the ED. Physicians have to manage 10 patients that appear concurrently, while also responding to a series of audio-visual distractors. Specifically, they must provide information on whether they will admit, transfer, or discharge the patients home. The investigators will calculate an under-triage rate for each physician (the number of simulated patients with severe injuries not transferred to a trauma center), summarize the under-triage rate by group (Night Shift v. educational control), and will compare the difference in those rates.

  After completion of the intervention

Secondary Outcomes (1)

• The effect of cognitive load on the under-triage rate

  After completion of the intervention

Study Arms (2)

Adventure video game

EXPERIMENTAL

Physicians in this arm of the trial will be asked to play Night Shift, an adventure video game, for one hour.

Behavioral: Night Shift

Educational Module

ACTIVE COMPARATOR

Physicians in this arm of the trial will be asked to use myATLS, an app designed by the American College of Surgeons to serve as an adjunct to the ATLS course, and Trauma Life Support MCQ Review, an app designed to help students prepare for the ATLS exam. They will be asked to spend at least one hour on the combined tasks.

Behavioral: Educational Module

Interventions

Night Shift BEHAVIORAL

Night Shift is an adventure video game with the transformational goal of teaching physicians key characteristics of patients with non-representative severe injuries - injuries classified by the American College of Surgeons as life-threatening or critical but that do not fit the archetype of injuries typically requiring treatment at a trauma center. Players take on the persona of Andy Jordan, a young emergency physician who moves home after the disappearance of his estranged grandfather (Robert Jordan) and takes up a job in the local Emergency Department (ED). In the preamble, players learn they have two explicit objectives. First, they must diagnose and treat patients who present to their ED. Second they must solve the mystery of Robert's disappearance: was he murdered or has he simply chosen to disappear?

Adventure video game

Educational Module BEHAVIORAL

The educational module consists of two separate apps, both commercially available. myATLS includes a review of each chapter of the Advanced Trauma Life Support (ATLS) textbook, a series of videos demonstrating common trauma procedures, and clinical resources including checklists for use at the bedside. Trauma Life Support MCQ Review includes 550 multiple-choice questions with correct answers and explanations. The investigators will ask physicians to review the myATLS app and then complete questions in the Trauma Life Support MCQ Review, spending at least 1 hour on the combined tasks.

Educational Module

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Physicians who care for adult patients in the Emergency Department.
• Physicians who work at a non-trauma center.
• Physicians who work at a Level III/IV trauma center.

You may not qualify if:

• Physicians who work at a Level I/II trauma center.
• Physicians who do not practice in the US.

Sponsors & Collaborators

• University of Pittsburgh: lead
• Carnegie Mellon University: collaborator

Related Publications (3)

• Mohan D, Rosengart MR, Fischhoff B, Angus DC, Wallace DJ, Farris C, Yealy DM, Barnato AE. Using incentives to recruit physicians into behavioral trials: lessons learned from four studies. BMC Res Notes. 2017 Dec 28;10(1):776. doi: 10.1186/s13104-017-3101-z.

  PMID: 29282154 DERIVED

• Mohan D, Farris C, Fischhoff B, Rosengart MR, Angus DC, Yealy DM, Wallace DJ, Barnato AE. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial. BMJ. 2017 Dec 12;359:j5416. doi: 10.1136/bmj.j5416.

  PMID: 29233854 DERIVED

• Mohan D, Rosengart MR, Fischhoff B, Angus DC, Farris C, Yealy DM, Wallace DJ, Barnato AE. Testing a videogame intervention to recalibrate physician heuristics in trauma triage: study protocol for a randomized controlled trial. BMC Emerg Med. 2016 Nov 11;16(1):44. doi: 10.1186/s12873-016-0108-z.

  PMID: 27835981 DERIVED

MeSH Terms

Conditions

Wounds and Injuries

Interventions

Shift Work Schedule

Intervention Hierarchy (Ancestors)

Personnel Staffing and Scheduling; Personnel Management; Organization and Administration; Health Services Administration

Study Officials

• Deepika Mohan, MD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: July 28, 2016
• First Posted: August 5, 2016
• Study Start: October 1, 2016
• Primary Completion: November 1, 2016
• Study Completion: November 1, 2016
• Last Updated: August 24, 2017

Record last verified: 2017-08

Data Sharing

• IPD Sharing: Will share