# Development of a serious game to measure physician implementation of trauma triage guidelines

> **NIH NIH R21** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $115,563

## Abstract

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, under-triage persists (incidence: 50%), particularly among those over the age of
65 (incidence: 80%). Causes of non-compliance with clinical practice guidelines varies among physicians.
Moreover, exposing physicians to inappropriate interventions can have serious unintended consequences. To
address the implementation gap, we therefore propose to develop a novel serious game (an applied video
game) to measure physician behavior in trauma triage and to identify sources of non-compliance. In Aim 1, we
will build the game using an established, user-centered design process that involves formative research with
stakeholders (n=20), prototype development, and then calibration through iterative play-testing with a national
convenience sample of physicians (n=30). In Aim 2, we will establish the initial measurement properties of the
game by recruiting a local convenience sample of physicians (n=100), auditing their charts, and conducting
semi-structured interviews so that we can assess internal consistency reliability, re-test reliability, criterion
validity, and convergent construct validity. This proposal will deliver a tool that can be used to inform the
selection of interventions in future efforts to increase the implementation of guidelines in trauma triage, and
thereby to improve patient outcomes after injury.

## Key facts

- **NIH application ID:** 10833160
- **Project number:** 5R21AG081724-02
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Deepika Mohan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $115,563
- **Award type:** 5
- **Project period:** 2023-05-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833160

## Citation

> US National Institutes of Health, RePORTER application 10833160, Development of a serious game to measure physician implementation of trauma triage guidelines (5R21AG081724-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10833160. Licensed CC0.

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