Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage
|ClinicalTrials.gov Identifier: NCT03279575|
Recruitment Status : Completed
First Posted : September 12, 2017
Last Update Posted : January 9, 2018
|Condition or disease||Intervention/treatment||Phase|
|Wounds and Injuries||Behavioral: Night Shift Behavioral: Graveyard Shift Behavioral: Educational program Behavioral: Control||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||320 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||1:1:1:1 allocation|
|Masking:||Single (Outcomes Assessor)|
|Masking Description:||We will mask the intervention status of participants when analyzing the data.|
|Official Title:||Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage: a Randomized Clinical Trial|
|Actual Study Start Date :||October 29, 2017|
|Actual Primary Completion Date :||December 11, 2017|
|Actual Study Completion Date :||December 11, 2017|
Experimental: Night Shift
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
Physicians in this arm of the trial will be asked to play Night Shift, an adventure video game, for two hours.
Experimental: Graveyard Shift
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
Physicians in this arm of the trial will be asked to play Graveyard Shift, a puzzle video game, for two hours.
Active Comparator: Educational program
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
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.
Placebo Comparator: Control
Physicians in this arm will not be asked to complete any intervention.
Physicians in this arm will serve as a no-contact control group.
- Incidence rate of successful triage [ Time Frame: One month after completion of the intervention ]
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).
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03279575
|United States, Pennsylvania|
|University of Pittsburgh|
|Pittsburgh, Pennsylvania, United States, 15213|