Testing the Effectiveness of Night Shift, a Theory-based Customized Video Game

NCT06063434 | Completed Results DMC

• 2 other identifiers: STUDY23070156R01AG076499
• Study Type: interventional
• Target: 800
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to test the effect of a video game on the implementation of clinical practice guidelines in trauma triage. The main question it attempts to answer is whether exposure to the game improves compliance with guidelines by emergency medicine physicians working at non-trauma centers in the US. Participants randomized to the intervention condition will be asked to play a customized, theory-based video game for 2 hours immediately after enrollment, and then return to the game for 20 minutes every three months for the next 9 months. Participants in the control condition will receive usual care.

Conditions

Trauma Injury; Physician's Role

Keywords

Heuristics; Serious game; Guidelines

Outcome Measures

Primary Outcomes (1)

• Under-triage

  Number of severely injured patients, treated by trial participants, who are admitted or discharged (i.e., not transferred) after initial evaluation at a non-trauma center as recommended by clinical practice guidelines.

  1 year

Secondary Outcomes (3)

• Mortality and Hospital Readmission

  1 year

• Functional Dependence

  1 year

• Over-triage

  1 year

Study Arms (2)

Night Shift

EXPERIMENTAL

Night Shift 2024 is a customized, theory-based adventure video game in which the player takes on the character of Andy Jordan, a young emergency medicine physician who moves home after the disappearance of his grandfather and takes a job at a local community hospital. The investigators will ask participants to play Night Shift for 2 hours upon enrollment (or within 2 weeks), and then come back to the game quarterly to play it again for 20 minute booster sessions. They will unlock additional game content each quarter to make the experience more enjoyable.

Behavioral: Night Shift

Usual education

ACTIVE COMPARATOR

Participants will receive their usual continuing medical education, but nothing additional.

Behavioral: Usual education

Interventions

Night Shift BEHAVIORAL

The player must not only manage the patients who present to the emergency department of the hospital, gaining experience with the consequences of trauma triage, but also solve the mystery of the grandfather, gaining an emotional connection with the character and making the feedback that "Andy" receives more relevant. Embedded within Night Shift 2024 is a mini-game (Graveyard Shift) that contains a series of puzzles that reinforce the lessons of the overarching game: transfer severely injured patients expeditiously.

Night Shift

Usual education BEHAVIORAL

Standard continuing medical education, including Advanced Trauma Life Support, and the American Board of Emergency Medicine educational modules (e.g., trauma resuscitation).

Usual education

Eligibility Criteria

• Age: 25 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \- Board certified physicians who work exclusively in the emergency departments (EDs) of non-trauma centers in the US AND triage adult trauma patients

You may not qualify if:

• non-physician healthcare professionals who work in EDs
• physicians who work at trauma and non-trauma centers
• physicians who work outside the continental US

Sponsors & Collaborators

• University of Pittsburgh: lead
• National Institute on Aging (NIA): collaborator

Study Sites (1)

University of Pittsburgh

Pittsburgh, Pennsylvania, 15213, United States

Location

Related Publications (3)

• Mohan D, Chang CH, Fischhoff B, Elmer J, Rak KJ, Barnes JL, Peitzman AB, Bendesky B, Carr C, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock MB, White DB, Angus DC. Using Serious Games to Increase the Implementation of Trauma Triage Guidelines: A Randomized Clinical Trial. JAMA. 2026 Apr 20. doi: 10.1001/jama.2026.4079. Online ahead of print.

  PMID: 42008277 DERIVED

• Mohan D, Fischhoff B, Talisa V, Elmer J, White DB, Angus DC, Peitzman A, Bendesky B, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock M, Chang CH. An Educational Video Game in Trauma Triage at Nontrauma Centers: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2513375. doi: 10.1001/jamanetworkopen.2025.13375.

  PMID: 40465299 DERIVED

• Mohan D, Angus DC, Chang CH, Elmer J, Fischhoff B, Rak KJ, Barnes JL, Peitzman AB, White DB. Using a theory-based, customized video game as an educational tool to improve physicians' trauma triage decisions: study protocol for a randomized cluster trial. Trials. 2024 Feb 16;25(1):127. doi: 10.1186/s13063-024-07961-w.

  PMID: 38365758 DERIVED

MeSH Terms

Conditions

Accidental Injuries

Interventions

Shift Work Schedule

Condition Hierarchy (Ancestors)

Wounds and Injuries

Intervention Hierarchy (Ancestors)

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

Limitations and Caveats

1. We used Medicare Fee-for-Service 2. We used claims for outcome assessment 3. We assigned process of care to the individual physician, but recognize the complex contextual nature of trauma triage 4. We provided a material incentive to encourage task completion 5. Although missingness of data was low, we cannot exclude a small residual bias. 6. Our public protocol disclosed block sizes of 4 or 6, creating a theoretical risk of allocation prediction.

Results Point of Contact

• Title: Dr. Deepika Mohan
• Organization: University of Pittsburgh

mohand@upmc.edu

4126470860

Study Officials

• Deepika Mohan, MD

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Participant assignment will be masked within the data with unblinding occurring only after data cleaning has completed.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Physicians will be randomized in a 1:1 fashion to the intervention condition or to the control condition.

Study Record Dates

• First Submitted: September 20, 2023
• First Posted: October 2, 2023
• Study Start: November 27, 2023
• Primary Completion: March 30, 2025
• Study Completion: March 30, 2025
• Last Updated: May 6, 2026
• Results First Posted: May 6, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ANALYTIC CODE
• Time Frame: 6 months after publication of the primary manuscript.
• Access Criteria: We will upload the data to the open ICPSR repository, where other researchers can access it.

Locations

US (1)