Testing the Efficacy of Two Behavioral Interventions at Recalibrating Physician Heuristics in Trauma Triage

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.

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.