Trauma InjuryNCT06063434
Testing the Effectiveness of Night Shift, a Theory-based Customized Video Game
A study testing Night Shift and Usual education in people with Trauma Injury and Physician's Role, run by University of Pittsburgh at 1 site in United States.
Trial summary
The goal of this clinical trial is to test the effect of a video game on the implementation of clinical practice guidelines in trauma triage. The main question it attempts to answer is whether exposure to the game improves compliance with guidelines by emergency medicine physicians working at non-trauma centers in the… Read more about this study
- Who is it for?
- Ages 25 to 70 years
- Conditions the study is for
- Trauma Injury, Physician's Role
- What is being tested?
- Night Shift and Usual education
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 800 participants
- Where
- 1 siteUnited States
- Study dates
- 27 Nov 2023to 30 Mar 2025
- Phase
- Interventional
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Board certified physicians who work exclusively in the emergency departments (EDs) of non-trauma centers in the US AND triage adult trauma patients
Who cannot join
- non-physician healthcare professionals who work in EDs
- physicians who work at trauma and non-trauma centers
- physicians who work outside the continental US
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Pittsburgh
Pittsburgh, Pennsylvania, 15213
About this study
Official title: Testing the Effectiveness of a Theory-based, Customized Video Game at Increasing the Implementation of Clinical Practice Guidelines in Trauma Triage
The goal of this clinical trial is to test the effect of a video game on the implementation of clinical practice guidelines in trauma triage. The main question it attempts to answer is whether exposure to the game improves compliance with guidelines by emergency medicine physicians working at non-trauma centers in the US. Participants randomized to the intervention condition will be asked to play a customized, theory-based video game for 2 hours immediately after enrollment, and then return to the game for 20 minutes every three months for the next 9 months. Participants in the control condition will receive usual care.
Read the detailed description
Transfer 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. The study team 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. The investigators 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.
- Conditions
- Trauma Injury, Physician's Role
- Being tested
- Night Shift, Usual education
- Keywords
- Heuristics, Serious game, Guidelines
- Medical subject headings
- Accidental Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Night ShiftBehavioural
The player must not only manage the patients who present to the emergency department of the hospital, gaining experience with the consequences of trauma triage, but also solve the mystery of the grandfather, gaining an emotional connection with the character and making the feedback that "Andy" receives more relevant. Embedded within Night Shift 2024 is a mini-game (Graveyard Shift) that contains a series of puzzles that reinforce the lessons of the overarching game: transfer severely injured patients expeditiously.
Usual educationBehavioural
Standard continuing medical education, including Advanced Trauma Life Support, and the American Board of Emergency Medicine educational modules (e.g., trauma resuscitation).
| Study group | Role | What they receive |
|---|---|---|
| Night Shift | Experimental | Night Shift 2024 is a customized, theory-based adventure video game in which the player takes on the character of Andy Jordan, a young emergency medicine physician who moves home after the disappearance of his grandfather and takes a job at a local community hospital. The investigators will ask participants to play Night Shift for 2 hours upon enrollment (or within 2 weeks), and then come back to the game quarterly to play it again for 20 minute booster sessions. They will unlock additional game content each quarter to make the experience more enjoyable. Receives: Behavioral: Night Shift |
| Usual education | Active comparator | Participants will receive their usual continuing medical education, but nothing additional. Receives: Behavioral: Usual education |
What is being measured
The primary outcome is the main question the study is designed to answer.
Under-triage
Number of severely injured patients, treated by trial participants, who are admitted or discharged (i.e., not transferred) after initial evaluation at a non-trauma center as recommended by clinical practice guidelines.
Measured: 1 year
Secondary outcomes (3)
Mortality and Hospital Readmission
Number of severely injured patients, treated by trial participants, who die or are readmitted to any hospital within 30 days of their initial evaluation at a non-trauma center
Measured: 1 year
Functional Dependence
Proportion of severely injured patients, treated by trial participants, with 90-day preadmission location at home with discharge to a skilled nursing or rehabilitation facility after initial treatment at a non-trauma center.
Measured: 1 year
Over-triage
Number of injured patients, treated by trial participants, transferred to a higher level of care after initial evaluation at a non-trauma center with minimal injuries. The Overall Number of Participants Analyzed reflects the number of enrolled physicians. The values in the data table report transferred patients treated by physicians enrolled in the trial.
Measured: 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Oct 2023
- Study start27 Nov 2023
- Primary completion30 Mar 2025
- Study completion30 Mar 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Trauma InjuryStudies of the same condition, open and under way.
- More trials run by University of PittsburghThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Physicians will be randomized in a 1:1 fashion to the intervention condition or to the control condition.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 800 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Pittsburgh
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Aging (NIA)
- Responsible party
- Principal investigator, Deepika Mohan, University of Pittsburgh
- Investigators
- Deepika Mohan, MD, Principal investigator, University of Pittsburgh
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06063434
- Sponsor's protocol ID
- STUDY23070156
- Other IDs
- R01AG076499
- Status last verified
- May 2026
- First submitted
- 20 Sep 2023
- Last updated
- 6 May 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: The protocol, primary data, and meta-data (e.g., documentation, protocols used to clean and to manage the data), will be uploaded to the open access Inter-university Consortium for Political and Social Research (open ICPSR) repository at the conclusion of the trial. Of note, data obtained from Medicare will not be shared as part of the results of the trial, because we do not own those records.
Publications
Mohan D, Chang CH, Fischhoff B, Elmer J, Rak KJ, Barnes JL, Peitzman AB, Bendesky B, Carr C, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock MB, White DB, Angus DC. Using Serious Games to Increase the Implementation of Trauma Triage Guidelines: A Randomized Clinical Trial. JAMA. 2026 May 19;335(19):1672-1683. doi: 10.1001/jama.2026.4079.
PubMed 42008277Mohan D, Fischhoff B, Talisa V, Elmer J, White DB, Angus DC, Peitzman A, Bendesky B, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock M, Chang CH. An Educational Video Game in Trauma Triage at Nontrauma Centers: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2513375. doi: 10.1001/jamanetworkopen.2025.13375.
PubMed 40465299Mohan D, Angus DC, Chang CH, Elmer J, Fischhoff B, Rak KJ, Barnes JL, Peitzman AB, White DB. Using a theory-based, customized video game as an educational tool to improve physicians' trauma triage decisions: study protocol for a randomized cluster trial. Trials. 2024 Feb 16;25(1):127. doi: 10.1186/s13063-024-07961-w.
PubMed 38365758
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Testing the Effectiveness of a Theory-based, Customized Video Game at Increasing the Implementation of Clinical Practice Guidelines in Trauma Triage
- ClinicalTrials.gov ID
- NCT06063434
- Acronym / sponsor ID
- STUDY23070156
- Conditions
- Trauma Injury, Physician's Role
- Keywords
- Heuristics, Serious game, Guidelines
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 800 participants (actual)
- Lead sponsor
- University of PittsburghUniversity, hospital or other
- Collaborators
- National Institute on Aging (NIA)
- Study start
- 27 Nov 2023 (actual)
- Primary completion
- 30 Mar 2025 (actual)
- Study completion
- 30 Mar 2025 (actual)
- First posted
- 2 Oct 2023 (actual)
- Results
- Posted 6 May 2026
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to test the effect of a video game on the implementation of clinical practice guidelines in trauma triage. The main question it attempts to answer is whether exposure to the game improves compliance with guidelines by emergency medicine physicians working at non-trauma centers in the US. Participants randomized to the intervention condition will be asked to play a customized, theory-based video game for 2 hours immediately after enrollment, and then return to the game for 20 minutes every three months for the next 9 months. Participants in the control condition will receive usual care.
Detailed description
Transfer 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. The study team 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. The investigators 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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Physicians will be randomized in a 1:1 fashion to the intervention condition or to the control condition.
| Arm | Type | Receives |
|---|---|---|
| Night Shift | Experimental | Behavioral: Night ShiftNight Shift 2024 is a customized, theory-based adventure video game in which the player takes on the character of Andy Jordan, a young emergency medicine physician who moves home after the disappearance of his grandfather and takes a job at a local community hospital. The investigators will ask participants to play Night Shift for 2 hours upon enrollment (or within 2 weeks), and then come back to the game quarterly to play it again for 20 minute booster sessions. They will unlock additional game content each quarter to make the experience more enjoyable. |
| Usual education | Active comparator | Behavioral: Usual educationParticipants will receive their usual continuing medical education, but nothing additional. |
Who may qualify
- Ages
- 25 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Board certified physicians who work exclusively in the emergency departments (EDs) of non-trauma centers in the US AND triage adult trauma patients
Key exclusion criteria (3 listed)
- non-physician healthcare professionals who work in EDs
- physicians who work at trauma and non-trauma centers
- physicians who work outside the continental US
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Night ShiftThe player must not only manage the patients who present to the emergency department of the hospital, gaining experience with the consequences of trauma triage, but also solve the mystery of the grandfather, gaining an emotional connection with the character and making the feedback that "Andy" receives more relevant. Embedded within Night Shift 2024 is a mini-game (Graveyard Shift) that contains a series of puzzles that reinforce the lessons of the overarching game: transfer severely injured patients expeditiously. | Behavioural | Night Shift |
| Usual educationStandard continuing medical education, including Advanced Trauma Life Support, and the American Board of Emergency Medicine educational modules (e.g., trauma resuscitation). | Behavioural | Usual education |
Primary outcome
Under-triage
Time frame: 1 year
Number of severely injured patients, treated by trial participants, who are admitted or discharged (i.e., not transferred) after initial evaluation at a non-trauma center as recommended by clinical practice guidelines.
3 secondary outcomes
Mortality and Hospital Readmission
Time frame: 1 year
Functional Dependence
Time frame: 1 year
Over-triage
Time frame: 1 year
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42008277Mohan D, Chang CH, Fischhoff B, Elmer J, Rak KJ, Barnes JL, Peitzman AB, Bendesky B, Carr C, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock MB, White DB, Angus DC. Using Serious Games to Increase the Implementation of Trauma Triage Guidelines: A Randomized Clinical Trial. JAMA. 2026 May 19;335(19):1672-1683. doi: 10.1001/jama.2026.4079.
- Derived from this study: PubMed 40465299Mohan D, Fischhoff B, Talisa V, Elmer J, White DB, Angus DC, Peitzman A, Bendesky B, Chapman AC, Forsythe RM, Guyette FX, Hynes AM, Oskvarek JJ, Weingart SD, Weinstock M, Chang CH. An Educational Video Game in Trauma Triage at Nontrauma Centers: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2513375. doi: 10.1001/jamanetworkopen.2025.13375.
- Derived from this study: PubMed 38365758Mohan D, Angus DC, Chang CH, Elmer J, Fischhoff B, Rak KJ, Barnes JL, Peitzman AB, White DB. Using a theory-based, customized video game as an educational tool to improve physicians' trauma triage decisions: study protocol for a randomized cluster trial. Trials. 2024 Feb 16;25(1):127. doi: 10.1186/s13063-024-07961-w.
- Individual participant dataSharing planned: Yes. The protocol, primary data, and meta-data (e.g., documentation, protocols used to clean and to manage the data), will be uploaded to the open access Inter-university Consortium for Political and Social Research (open ICPSR) repository at the conclusion of the trial. Of note, data obtained from Medicare will not be shared as part of the results of the trial, because we do not own those records.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Deepika Mohan, MD principal investigator
University of Pittsburgh
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Night Shift and Usual education in people with Trauma Injury and Physician's Role, run by University of Pittsburgh at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Yes. Results are posted in the registry (first posted 6 May 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Under-triage (time frame: 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06063434, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.