Trial of a Video Game Intervention to Recalibrate Physician Heuristics: A Followup Study

NCT03138304 | Completed

• 1 other identifier: MOD16070572-03 / PRO16070572
• Study Type: interventional
• Target: 142
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to measure the duration of two different types of interventions to change physician decision making in trauma triage: a video game and an educational program.

Conditions

Wounds and Injuries

Keywords

decision making; heuristics

Outcome Measures

Primary Outcomes (1)

• Undertriage

  Physicians in both arms of the study will be asked to complete an outcome assessment tool - a virtual simulation - six months after completion of their intervention. 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), will summarize the under-triage rate by group (Night Shift v. educational control), and will assess the difference in those rates.

  6 months after completion of the intervention

Secondary Outcomes (2)

• Undertriage for nonrepresentative and representative injuries

  6 months after completion of the intervention

• Degradation in treatment effect

  6 months after completion of the intervention.

Study Arms (2)

Adventure video game

EXPERIMENTAL

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?

Behavioral: Video game

Educational Program

ACTIVE COMPARATOR

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.

Behavioral: Educational program

Interventions

Video game 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.

Adventure video game

Educational program BEHAVIORAL

Two commercially available applications designed to teach physicians the trauma triage guidelines disseminated by the American College of Surgeons.

Educational Program

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• 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 only at a Level I/II trauma center.
• Physicians who do not practice in the US.

Sponsors & Collaborators

• University of Pittsburgh: lead
• National Institutes of Health (NIH): collaborator

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15261, United States

Location

Related Publications (1)

• 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

MeSH Terms

Conditions

Wounds and Injuries

Study Officials

• Deepika Mohan, MD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Group assignment will be masked at the analysis phase.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor of critical care medicine

Study Record Dates

• First Submitted: April 30, 2017
• First Posted: May 3, 2017
• Study Start: May 2, 2017
• Primary Completion: June 1, 2017
• Study Completion: June 1, 2017
• Last Updated: August 24, 2017

Record last verified: 2017-08

Data Sharing

• IPD Sharing: Will share

Locations

US (1)