Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage

NCT03279575 | Completed

• 1 other identifier: PRO17090094
• Study Type: interventional
• Target: 320
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to compare the efficacy of two behavioral interventions at recalibrating physician heuristics.

Conditions

Wounds and Injuries

Outcome Measures

Primary Outcomes (1)

• Incidence rate of successful triage

  Physicians in all arms of the study will be asked to complete a virtual 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 categorize severely injured patients as successfully transferred (transferred to a trauma center or died in the ED) or not (admitted). We will use a Poisson regression to estimate the association between successful transfer and exposure to the different interventions (Night Shift v. Graveyard Shift v. educational program v. control).

  One month after completion of the intervention

Study Arms (4)

Night Shift

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: Night Shift

Graveyard Shift

EXPERIMENTAL

Graveyard Shift is a puzzle video game with the transformational goal of helping physicians derive key triage decision principles for themselves. They complete a three-step game loop to obtain case information, compare cases to determine similarities and differences between cases, and then explicitly state the decision principle that should drive decision making.

Behavioral: Graveyard Shift

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 com

Behavioral: Educational program

Control

PLACEBO COMPARATOR

Physicians in this arm will not be asked to complete any intervention.

Behavioral: Control

Interventions

Night Shift BEHAVIORAL

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

Night Shift

Graveyard Shift BEHAVIORAL

Physicians in this arm of the trial will be asked to play Graveyard Shift, a puzzle video game, for two hours.

Graveyard Shift

Educational program BEHAVIORAL

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 two hours on the combined tasks.

Educational program

Control BEHAVIORAL

Physicians in this arm will serve as a no-contact control group.

Control

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Emergency medicine physicians who work at a non-trauma center.
• Emergency medicine physicians who work at a Level III/IV trauma center.

You may not qualify if:

• Emergency medicine physicians who work only at a Level I/II trauma center.
• Emergency medicine physicians who do not practice in the US.

Sponsors & Collaborators

• University of Pittsburgh: lead

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

Location

Related Publications (1)

• Mohan D, Fischhoff B, Angus DC, Rosengart MR, Wallace DJ, Yealy DM, Farris C, Chang CH, Kerti S, Barnato AE. Serious games may improve physician heuristics in trauma triage. Proc Natl Acad Sci U S A. 2018 Sep 11;115(37):9204-9209. doi: 10.1073/pnas.1805450115. Epub 2018 Aug 27.

  PMID: 30150397 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 Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: We will mask the intervention status of participants when analyzing the data.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor of critical care medicine

Model Details: 1:1:1:1 allocation

Study Record Dates

• First Submitted: September 7, 2017
• First Posted: September 12, 2017
• Study Start: October 29, 2017
• Primary Completion: December 11, 2017
• Study Completion: December 11, 2017
• Last Updated: January 9, 2018

Record last verified: 2018-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

US (1)