NCT03279575

Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage

Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage: a Randomized Clinical Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 320 (actual)
• Sponsor: University of Pittsburgh · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

The objective of this study is to compare the efficacy of two behavioral interventions at recalibrating physician heuristics.

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 two separate behavioral interventions to recalibrate physician heuristics in trauma triage, and will compare the effect of these interventions, an educational program, and no intervention on physician performance on a virtual simulation.

Conditions

• Wounds and Injuries

Interventions

Type	Name	Description
BEHAVIORAL	Night Shift	Physicians in this arm of the trial will be asked to play Night Shift, an adventure video game, for two hours.
BEHAVIORAL	Graveyard Shift	Physicians in this arm of the trial will be asked to play Graveyard Shift, a puzzle video game, for two hours.
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.
BEHAVIORAL	Control	Physicians in this arm will serve as a no-contact control group.

Timeline

• Start date: 2017-10-29
• Primary completion: 2017-12-11
• Completion: 2017-12-11
• First posted: 2017-09-12
• Last updated: 2018-01-09

Locations

1 site across 1 country: United States