A Randomized Controlled Trial of a Video Game Intervention to Recalibrate Physician Heuristics
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Wounds and Injuries
- Sponsor
- University of Pittsburgh
- Enrollment
- 368
- Primary Endpoint
- Under-triage rate
- Status
- Completed
- Last Updated
- 8 years ago
Overview
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.
Detailed 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 have developed an adventure video game (Night Shift) to serve as a novel method of recalibrating physician heuristics in trauma triage and will compare its efficacy with a standard educational program.
Investigators
Deepika Mohan
MD
University of Pittsburgh
Eligibility Criteria
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 at a Level I/II trauma center.
- •Physicians who do not practice in the US.
Outcomes
Primary Outcomes
Under-triage rate
Time Frame: After completion of the intervention
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.
Secondary Outcomes
- The effect of cognitive load on the under-triage rate(After completion of the intervention)