Emergency Physicians Improve Trauma Triage Skills with Video Game Training, Study Finds

Emergency physicians who played a specially designed video game showed significantly better performance in triaging severely injured older adults compared to those who received standard continuing education, according to a latest study published in JAMA.

The randomized clinical trial, led by researchers at the University of Pittsburgh and UPMC, found that physicians who played the serious game “Night Shift” were more likely to adhere to trauma triage guidelines for patients over 65—a group that is frequently undertriaged in emergency departments.

Addressing a Critical Gap in Emergency Care

Older adults who suffer serious injuries are often undertriaged because their symptoms can appear less severe than they actually are. For example, an older person with four rib fractures from a fall faces a similar risk of death as a younger person with a liver gunshot wound, yet these injuries may be overlooked during initial assessment.

Research indicates that seriously injured older adults are undertriaged as much as 70% of the time in emergency departments, creating a significant patient safety concern as the population ages.

How the Video Game Training Works

The “Night Shift” video game was developed by a team of surgeon-scientists from UPMC and the University of Pittsburgh in collaboration with Carnegie Mellon University and Schell Games. Designed as a theory-based serious game, it aims to subconsciously modify ingrained decision-making patterns (heuristics) that can lead to triage errors.

Unlike traditional continuing medical education, which relies on lectures and didactic instruction, the game uses interactive scenarios to help physicians recognize subtle signs of severe injury in older patients through repeated practice and feedback.

Study Design and Key Findings

The trial included 800 physicians staffing non-trauma center emergency departments. Participants were randomly assigned to either complete standard continuing medical education or play the “Night Shift” video game over a 12-month period beginning in 2024.

Results showed that physicians who played the game demonstrated significantly improved adherence to trauma triage guidelines for severely injured older adults compared to their peers who received only traditional education.

The findings were published in JAMA on April 20, 2026.

Implications for Medical Training and Patient Safety

Study authors suggest that video game-based training could serve as an effective, scalable alternative to costly and time-consuming recertification courses. By targeting the cognitive biases that contribute to undertriage, such interactive tools may help reduce preventable deaths among older trauma patients.

Lead author Deepika Mohan, associate professor of surgery and critical care medicine at the University of Pittsburgh School of Medicine and a trauma surgeon at UPMC, emphasized the importance of improving triage practices: “An increasing proportion of seriously injured patients are older than 65 and when they come into the emergency department, they are undertriaged because their injuries are more insidious.”

The Future of Serious Games in Medicine

This research adds to growing evidence that serious games—video games designed for purposes beyond entertainment—can play a meaningful role in medical education and clinical decision-making. As healthcare systems seek innovative ways to maintain physician competency, interactive training tools like “Night Shift” may become a standard component of continuing education.

For now, the study provides strong support for exploring game-based learning strategies to address specific clinical blind spots, particularly in high-stakes areas like trauma care where split-second decisions can imply the difference between life and death.