No one masters a skill without mistakes, but when you’re a health care provider, screw ups can be deadly.
In 2016, the National Academy of Sciences found that every year up to 30,000 civilian and military deaths of trauma patients could be prevented if the injured people had received optimal care.
A new video game developed by a critical care doctor at the University of Pittsburgh aims to help emergency medicine physicians build trauma expertize in a low-stakes environment.
“Night Shift” isn’t super flashy – think mid-'80s Nintendo – but the story is very “Grey’s Anatomy.” It stars Andy Jordan, a young emergency department doctor who favors v-neck shirts.
Andy spends the game trying to solve a mystery surrounding his grandfather while also treating trauma patients, such as Steven who has just arrived at the hospital with a gunshot wound.
“We intubated him. We put in large bore IVs. We’re going to him a couple liters of fluid,” said UPMC critical care doctor Deepika Mohan as she demonstrated the game she designed with the help of Pittsburgh-based Schell Games. “And then we’re going to give him some blood. We’re going to tell the nurse to go get me as much blood as they’ll give me from the blood bank. We saved him."
That game is geared towards improving the trauma triage skills of emergency department doctors. Mohan said she got the idea from research showing people learn through stories.
In fact, during pre-testing, Mohan found that the game’s clinical lessons resonated more strongly the more people identified with Andy. The plot line with the grandfather fleshes out Andy’s character, which makes easier to empathize with him.
“So, it turns out there was a military base in the town, and you found that his grandfather worked for the military for a while,” she said. “It was all very hush-hush.”
To test its effectiveness, Mohan compared physicians who played “Night Shift” to those who studied traditional educational materials on triage. She found that, six months after these enrichments, when both groups participated in a simulation, the group that did the traditional education were 17 percent more likely to underestimate the seriousness of a patient’s injury or illnesses.
“Where my eyes kind of light up at this is the idea that this could supplement our residents’ education in a variety of ways, not just for trauma,” said Dr. Megan Ranney, who directs the Emergency Digital Health Innovation Program at Brown University’s Alpert Medical School in Providence, RI.
Ranney said since most triage is performed by nurses or emergency medical services workers, physicians might actually be the wrong audience for “Night Shift.”
But based on the results of Mohan’s study, Ranney’s excited by the possibility of video games. For example, she thinks games could help young doctors hone their medical judgment, especially because residency programs now limit the hours someone can work.
“Our trainees are having less time in the clinical environment,” she said. “Particularly for some rare diseases or rare procedures, those duty-hour restrictions mean they may not be seeing as many cases as they would have back in the days when we worked 120-hour weeks as residents.”
“Night Shift” still has a few kinks. Physicians who played reported the game was buggy. And the jury’s still out on whether it helps doctors treat real people, or if the game’s success is limited to training simulations.