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

Wounds and Injuries Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03138304
• Other study ID #: MOD16070572-03 / PRO16070572
• Status: Completed
• Phase: N/A
• First received: April 30, 2017
• Last updated: August 22, 2017
• Start date: May 2, 2017
• Est. completion date: June 1, 2017

Study information

• Verified date: August 2017
• Source: University of Pittsburgh
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Description:

Treatment at trauma centers improves outcomes for patients with moderate-to-severe injuries. Accordingly, professional organizations, state authorities, and the federal government have endorsed the systematic triage and transfer of these patients to trauma centers either directly from the field or after evaluation at a non-trauma center. Nonetheless, between 30 to 40% of patients with moderate-to-severe injuries still only receive treatment at non-trauma centers, so-called under-triage. Most of this under-triage occurs because of physician decisions (rather than first-responder decisions). Existing efforts to change physician decision making focus primarily on knowledge of clinical practice guidelines and attitudes towards the guidelines. These strategies ignores the growing consensus that decision making reflects both knowledge as well as intuitive judgments (heuristics). Heuristics, mental short cuts based on pattern recognition, drive the majority of decision making. The investigators developed an adventure video game (Night Shift) to serve as a novel method of recalibrating physician heuristics in trauma triage and compared its efficacy with a standard educational program. This study is designed to measure the degradation of the treatment effect.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 142
• Est. completion date: June 1, 2017
• Est. primary completion date: June 1, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• 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.

Exclusion Criteria:

• Physicians who work only at a Level I/II trauma center.

• Physicians who do not practice in the US.

Related Conditions & MeSH terms

• Wounds and Injuries

Intervention

Behavioral:
• Video game
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.
• Educational program
Two commercially available applications designed to teach physicians the trauma triage guidelines disseminated by the American College of Surgeons.

Locations

Country	Name	City	State
United States	University of Pittsburgh	Pittsburgh	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
University of Pittsburgh	National Institutes of Health (NIH)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	Undertriage for nonrepresentative and representative injuries	We will categorize severely injured patients on the virtual simulation (the outcome assessment tool) as having representative or non-representative injuries. We will summarize the undertriage rate of representative/non-representative injuries by intervention, and will compare the difference in those rates between groups.	6 months after completion of the intervention
Secondary	Degradation in treatment effect	We will compare the undertriage rate of physicians the first and second time they complete the virtual simulation (time zero = initial enrollment; time one = six months post intervention). We will compare the difference in the undertriage rates by intervention.	6 months after completion of the intervention.