# Using video games to increase implementation of clinical practice guidelines in trauma triage

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $594,828

## Abstract

PROJECT ABSTRACT
Injury is the leading cause of loss of independence among those over the age 65, resulting in over 3 million
Emergency Department (ED) visits, 800,000 hospitalizations, and greater than $50 billion in costs each year.
Guideline-concordant triage of trauma patients – rapid identification of those with severe injuries and transfer to
trauma centers – decreases mortality by 10 to 25%, reduces loss of independence, and diminishes pain at one
year. Despite this evidence, however, under-triage persists (incidence: 50%), particularly among those over the
age of 65 (incidence: 80%). To address this implementation gap, we propose to conduct a Type I hybrid
effectiveness-implementation trial in which we test the effect of video game-based training on physician
behavior. We designed this trial based on extensive preliminary studies, during which we isolated physician
behavior as the single largest source of variation in triage practices, identified heuristics (pattern recognition)
as a major cause of behavior, developed theory-based, customized video games to recalibrate physician
heuristics (i.e., align them with clinical practice guidelines), and ensured their efficacy in the laboratory. For this
trial, we will recruit a national sample of emergency medicine physicians (n=900), in collaboration with three
large staffing organizations, and will randomize physicians to one of three interventions: video game-based
training, text-based education (active control), or nothing (passive control). The specific aims of the trial are (1)
to test the effect of the three interventions on behavioral (e.g., under-triage) and patient-centered outcomes
(e.g., 30-day mortality) by linking trial data to Medicare claims, (2) to compare the mechanisms of action by
which the active interventions affect physician behavior by using a suite of validated instruments, and (3) to
identify contextual factors that influence implementation and maintenance of guidelines in practice by
performing a comprehensive qualitative evaluation of trial participants (n=20) and a national sample of key
decision makers (e.g., ED directors, patients [n=20/group]). Together these aims will provide critical insight into
the effectiveness of our novel intervention and key data to inform future implementation efforts.

## Key facts

- **NIH application ID:** 10808140
- **Project number:** 5R01AG076499-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Deepika Mohan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $594,828
- **Award type:** 5
- **Project period:** 2023-03-15 → 2027-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10808140

## Citation

> US National Institutes of Health, RePORTER application 10808140, Using video games to increase implementation of clinical practice guidelines in trauma triage (5R01AG076499-02). Retrieved via AI Analytics 2026-05-31 from https://api.ai-analytics.org/grant/nih/10808140. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*