Emergency departments face a critical challenge in trauma care for older adults, where standard triage protocols often fail to account for age-related physiological differences. Poor adherence to specialized guidelines can result in undertriage, sending severely injured older patients to facilities lacking appropriate trauma capabilities rather than dedicated trauma centers where outcomes improve significantly. A randomized controlled trial involving 368 emergency physicians tested whether interactive serious gaming could enhance compliance with evidence-based trauma triage protocols specifically designed for older adults. The gaming intervention incorporated behavioral theory principles and realistic clinical scenarios to train physicians in recognizing subtle injury patterns that traditional protocols might miss in patients over 65. Participants using the game-based training showed measurably improved adherence to age-appropriate triage guidelines compared to standard educational approaches. This represents a noteworthy advancement in medical education methodology, demonstrating that gamification can translate into meaningful clinical behavior change rather than merely improving test scores. The trauma care landscape has increasingly recognized that older adults require modified assessment approaches due to factors like medication effects, comorbidities, and altered physiological responses to injury. However, implementing these nuanced protocols in high-pressure emergency settings has proven challenging through conventional training methods. While this single-institution study shows promise, broader implementation would require validation across diverse emergency department settings and assessment of long-term retention of improved practices. The approach could potentially extend beyond trauma care to other areas where complex clinical guidelines struggle with real-world adherence.