Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage
2018年1月8日 更新者：Deepika Mohan、University of Pittsburgh
Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage: a Randomized Clinical Trial
The objective of this study is to compare the efficacy of two behavioral interventions at recalibrating physician heuristics.
研究概览
详细说明
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.
研究类型
介入性
注册 (实际的)
320
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Pennsylvania
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Pittsburgh、Pennsylvania、美国、15213
- University of Pittsburgh
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 孩子
- 成人
- 年长者
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Emergency medicine physicians who work at a non-trauma center.
- Emergency medicine physicians who work at a Level III/IV trauma center.
Exclusion Criteria:
- Emergency medicine physicians who work only at a Level I/II trauma center.
- Emergency medicine physicians who do not practice in the US.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：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?
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Physicians in this arm of the trial will be asked to play Night Shift, an adventure video game, for two hours.
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实验性的：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.
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Physicians in this arm of the trial will be asked to play Graveyard Shift, a puzzle video game, for two hours.
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有源比较器：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
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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.
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安慰剂比较：Control
Physicians in this arm will not be asked to complete any intervention.
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Physicians in this arm will serve as a no-contact control group.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Incidence rate of successful triage
大体时间：One month after completion of the intervention
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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). |
One month after completion of the intervention
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2017年10月29日
初级完成 (实际的)
2017年12月11日
研究完成 (实际的)
2017年12月11日
研究注册日期
首次提交
2017年9月7日
首先提交符合 QC 标准的
2017年9月11日
首次发布 (实际的)
2017年9月12日
研究记录更新
最后更新发布 (实际的)
2018年1月9日
上次提交的符合 QC 标准的更新
2018年1月8日
最后验证
2018年1月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- PRO17090094
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
是的
IPD 计划说明
De-identified data will be made available on application to the investigator team.
IPD 共享支持信息类型
- 研究方案
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
Night Shift的临床试验
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Yohanes Firmansyah, dr, MH, MMUniversitas Tarumanagara尚未招聘
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Massachusetts General HospitalNational Cancer Institute (NCI)招聘中
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