Evidence map›Paper›PMID 38365758›Full record

ArticleTrials2024

Using a theory-based, customized video game as an educational tool to improve physicians' trauma triage decisions: study protocol for a randomized cluster trial.

Deepika Mohan, Derek C Angus, Chung-Chou H Chang, Jonathan Elmer, Baruch Fischhoff, Kim J Rak, Jacqueline L Barnes, Andrew B Peitzman, Douglas B White

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06063434 (Testing the Effectiveness of a Theory-based, Customized Video Game at Increasing the Implementation of Clinical Practice Guidelines in Trauma Triage), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06063434 nacompletednot on this map

Testing the Effectiveness of a Theory-based, Customized Video Game at Increasing the Implementation of Clinical Practice Guidelines in Trauma Triage

TypeinterventionalSponsorUniversity of PittsburghRan2023 to 2025Enrolled800ConditionsTrauma Injury, Physician's RoleArmsNight Shift, Usual education
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Deepika MohanDepartment of Surgery, University of Pittsburgh School of Medicine, F1265 PUH, 200 Lothrop St, Pittsburgh, PA, 15213, USA. mohand@upmc.edu.ORCID http://orcid.org/0000-0003-2063-0811
Derek C AngusDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Chung-Chou H ChangDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jonathan ElmerDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Baruch FischhoffDepartment of Engineering and Environmental Policy, Carnegie Mellon University, Pittsburgh, PA, USA.
Kim J RakDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jacqueline L BarnesDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Andrew B PeitzmanDepartment of Surgery, University of Pittsburgh School of Medicine, F1265 PUH, 200 Lothrop St, Pittsburgh, PA, 15213, USA.
Douglas B WhiteDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Funding

Using video games to increase the implementation of clinical practice guidelines in trauma triageR01AG076499 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Deepika Mohan · 2023 to 2026
$2.3M
A novel intervention to make heuristics a source of power for physiciansDP2LM012339 · NLM · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI MOHAN, DEEPIKA · 2015 to 2015
$2.3M
Quantitative electroencephalography after cardiac arrestK23NS097629 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ELMER, JONATHAN · 2017 to 2021
$945k
Mentored Patient Oriented Research in Improving Surrogate Decision Making for Patients with Advanced Respiratory FailureK24HL148314 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Douglas B White · 2019 to 2026
$944k
NHLBI NIH HHS K24 HL148314NHLBI NIH HHS K24HL148314NIA NIH HHS R01 AG076499NINDS NIH HHS K23 NS097629NLM NIH HHS DP2 LM012339
6 · The paper itself

Abstract

backgroundTransfer of severely injured patients to trauma centers, either directly from the field or after evaluation at non-trauma centers, reduces preventable morbidity and mortality. Failure to transfer these patients appropriately (i.e., under-triage) remains common, and occurs in part because physicians at non-trauma centers make diagnostic errors when evaluating the severity of patients' injuries. We developed Night Shift, a theory-based adventure video game, to recalibrate physician heuristics (intuitive judgments) in trauma triage and established its efficacy in the laboratory. We plan a type 1 hybrid effectiveness-implementation trial to determine whether the game changes physician triage decisions in real-life and hypothesize that it will reduce the proportion of patients under-triaged.

methodsWe will recruit 800 physicians who work in the emergency departments (EDs) of non-trauma centers in the US and will randomize them to the game (intervention) or to usual education and training (control). We will ask those in the intervention group to play Night Shift for 2 h within 2 weeks of enrollment and again for 20 min at quarterly intervals. Those in the control group will receive only usual education (i.e., nothing supplemental). We will then assess physicians' triage practices for older, severely injured adults in the 1-year following enrollment, using Medicare claims, and will compare under-triage (primary outcome), 30-day mortality and re-admissions, functional independence, and over-triage between the two groups. We will evaluate contextual factors influencing reach, adoption, implementation, and maintenance with interviews of a subset of trial participants (n = 20) and of other key decision makers (e.g., patients, first responders, administrators [n = 100]). DISCUSSION: The results of the trial will inform future efforts to improve the implementation of clinical practice guidelines in trauma triage and will provide deeper understanding of effective strategies to reduce diagnostic errors during time-sensitive decision making.

trial registrationClinicalTrials.gov; NCT06063434 . Registered 26 September 2023.

Indexed as

PhysiciansVideo GamesAgedEmergency Service, HospitalHumansMedicareRandomized Controlled Trials as TopicTriageUnited StatesClinical practice guidelinesDeliberate practiceDiagnostic skillHeuristicsPhysiciansRandomized controlled trialTrauma triage

Identifiers

PMID38365758
PMCPMC10870723

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.