• Posted April 22, 2026

Video Game Training Sharpens ER Doctors’ Split-Second Decisions

Imagine if "The Pitt" – a high-intensity HBO Max drama about life and death in a Pittsburgh ER – was turned into a video game.

It’s already happened, in a way, and that game is helping ER doctors hone their ability to make quick life-saving judgments, a new study says.

The tablet-based game, Night Shift, places players in the role of a young emergency physician triaging trauma patients, including puzzles that must be solved in under 90 seconds with limited clinical information.

ER doctors who played the game did a better job than other physicians at accurately judging the care needed by severely injured older adults, researchers reported April 20 in the Journal of the American Medical Association.

“An increasing proportion of seriously injured patients are older than 65 and, unfortunately, when they come into the emergency department, they are under-triaged because their injuries are more insidious,” said lead researcher Dr. Deepika Mohan, a trauma surgeon at the University of Pittsburgh Medical Center.

“People may not think a rib fracture is a big deal,” she said in a news release. “But if an older person falls and suffers four rib fractures, their risk of dying is the same as a young person shot in the liver.”

Triaging seriously injured patients in the ER involves split-second decisions, as anyone who’s watched "The Pitt" can attest.

Doctors quickly assess everything they know about a patient and their injuries, then decide the right level of care, researchers said.

That decision could involve discharging patients to recover at home, steering them to an operating table, or even calling a helicopter to transfer them to another hospital with better trauma expertise.

Seniors are under-triaged at least 70% of the time, researchers said – that is, their condition is considered less severe than it actually is.

Mohan created the first version of Night Shift – now available as an Apple app – in 2016 with Schell Games, a Pittsburgh-based educational and entertainment game development company.

The game is aimed at helping emergency physicians subconsciously learn from good and bad decision-making without impacting real patients, researchers said.

To test its effectiveness, Mohan and colleagues recruited 800 ER physicians and randomly assigned half of them to play Night Shift – for two hours at first, and then quarterly for 20 minutes. The other half received the regular continuing education sessions all ER docs need to maintain their certification.

Doctors who played the game had lower rates of under-triaging severely injured seniors in real-life emergency departments — 49%, compared to 57% for those only receiving continuing education, results showed.

At the same time, both groups had the same rate of over-triaging, or treating an injury as more serious than it really is, researchers found.

Overall, the results indicate that the game didn’t just increase doctors’ willingness to transfer injured patients, but might have improved their diagnostic abilities.

The way the game uses storytelling to tap into emotions and puzzles to shape decision making could be rewriting doctors’ ingrained behaviors and improving their judgment, Mohan said.

However, she noted that doctors who played the game made their best decisions within 30 days of play, with the effect fading until they picked up Night Shift again.

“Quarterly exposure for 20 minutes may not be the best 'dose,’ ” Mohan said. “Perhaps playing the game more frequently and for less time would be better – maybe even a ‘microdose’ of 90 seconds each week.”

More information

The U.S. Centers for Disease Control and Prevention has more on common injures while aging.

SOURCE: University of Pittsburgh, news release, April 20, 2026