A novel escape room to prepare students for clinical rotations

Objective or purpose of innovation: To teach, through a game-based, escape room format, key clinical skills needed to manage common patient care scenarios in core clerkships.

Background and/or theoretical framework and importance to the field: Escape rooms are themed games, involving groups of players cooperating to solve puzzles. The interactivity and emphasis on goal-oriented collaboration have led to the adaptation of escape rooms for educational purposes, with evidence suggesting that game-based instruction may have advantages over traditional didactics for knowledge and/or skill acquisition. The transition to clinical rotations represents a challenging and often stressful period in undergraduate medical training, given the new skills and expectations compared to classroom learning. Escape rooms may facilitate this transition by introducing aspects of clinical work in a low-stakes, immersive setting.

Design: Students beginning their core clerkship year participated in an escape room activity prior to starting their rotations (n=49). Learning objectives included recognizing the initial approach to resuscitation in an emergent care scenario; identifying common surgical tubes, lines, and drains; and practicing teamwork skills. The escape room puzzles were constructed to provide repetitive, hands-on practice of clinical and procedural skills. Learners spent 60 minutes immersed in the escape room, followed by a 30-minute debriefing.

Outcomes: Student survey data showed a significant increase in self-reported knowledge related to the learning objectives (p<0.001) and increased excitement about the upcoming core clerkship year after participation in the escape room. Students strongly preferred the escape room format to traditional methods of instruction.

Innovation’s strengths and limitations: This activity was well received by learners and resulted in self-reported gains in knowledge. More work is needed to study the effects of this introductory activity on knowledge retention and clerkship performance.

Feasibility and generalizability: The foundational content covered in the activity is applicable to all students entering clinical rotations. While it incorporates the use of part-task trainers, adaptations can be made for lower resourced settings by prioritizing knowledge acquisition over skills practice.