IAMSE Winter 2023 Session 3 Highlights

[The following notes were generated by Thomas Thesen, Ph.D.]

Presenter: Amy Beresheim, PhD and Adam WilsonPhD (Rush University, USA)

Escape Rooms: Breaking Away from the Lull of Lackluster Curricula

The Winter 2023 IAMSE Webinar Seminar Series, titled “Not Just Fun & Games: Game-based Learning in Health Professions Education,” had its third session on Thursday, January 19. This series explores the benefits of using games in healthcare education and offers strategies for incorporating different types of games into the basic science curriculum. It covers existing literature on the theories behind using games in medical education and the results of recent research studies on the topic. The series also features speakers who will provide practical tips for implementing game-based learning in the classroom. The third session was presented by Dr. Amy Beresheim, Ph.D. and Dr. Adam Wilson, Ph.D. and was titled “Escape Rooms: Breaking away from the lull of lackluster curricula”.

Drs. Beresheim and Wilson started by explaining that Gamification is a field of educational science that aims to make learning more engaging and motivating using game-related mechanisms. They further highlighted that game-based learning typically includes a system with pre-defined rules, which allows individuals or groups to track their progress and receive incentives as they advance. They also emphasized that immediate incentives could enhance learning and promote engagement with the learning process. The presenters continued by giving an overview of the current literature on gamification in education. They cited several meta-analyses that support the effectiveness of gamification in enhancing student performance. According to one study, students exposed to educational games had higher performance outcomes than non-gaming control groups. Another meta-analysis found that gamification had small positive effects on cognitive, motivational, and behavioral learning outcomes. A third study reported a moderately positive effect of gamification on student achievement.

Drs. Beresheim and Wilson then shifted to the main topic of their talk, the concept of escape rooms, explaining that the goal is to escape a theme room using a series of clues within a specific time frame, usually 60 minutes. They went on to describe the mechanics of an escape room game, saying that it typically begins with a storyline to provide context for the environmental setting and the need for escape. Participants then search for clues and solve puzzles throughout the room in hopes of activating something, such as unlocking a combination device to reveal another clue. At first, the search may feel aimless but as more clues are decoded, it becomes easier to anticipate what additional steps are needed to complete the escape. They also mentioned additional features, such as the common use of distractors and the creation of time pressure to escape the room before the clock runs out.

Next, they discussed how escape rooms can be utilized in a medical education setting. The presenters stated that the primary objective should be to review or practice new educational content through an interactive and collaborative approach. The secondary goal should be to solve the puzzles and escape the room within a given time frame. They mentioned that the medical education escape room still begins with a storyline to establish the context and objectives and tie everything together. They also noted that there are still elements that can distract from the main objective (i.e. distractors), but the key difference in an educational escape room is that the puzzles and clues are designed to test the application of knowledge rather than just finding them. When knowledge is applied correctly, it will either reveal a new clue or help solve parallel ones that will eventually lead to the escape.

Drs. Beresheim and Wilson then delved into the topic of group size and dynamics in escape rooms. They

mentioned that groups can range in size, but generally have around 5 participants. They also emphasized that the ideal environment is usually fast paced, generating a high rate of communication among team members. Additionally, they pointed out that there is evidence that older and more educated players tend to speak for longer during the game. Furthermore, the prior strength of relationships within the group is linked to the intensity of collaboration and problem-solving interactions.

Next, the team discussed the difference between in-person and virtual escape rooms in educational settings. The majority of escape rooms used in education contexts are occurring in-person, and much smaller percentage constitute digital games or hybrid formats. They also mentioned that there are few comparative studies that have examined the effectiveness of in-person vs virtual/digital educational escape rooms. He cited one study that suggests that remote educational escape rooms can be as engaging as their face-to-face counterparts, but their learning effectiveness may be lower. As we now all know, virtual escape rooms offer logistical advantages such as being able to use them in case of COVID-19, saving space and time, reducing resource costs and allowing for reproducibility. The cost of running escape rooms is low and logistical issues are similar to small group sessions already common in medical education. They emphasized that educators must ensure that all participants have the dexterity and motor skills required for in-person puzzles, and think about the overall challenges that some individual students with extra challenges may encounter. They then went on to describe various escape room implementations with a focus on anatomy at the University of Alabama and Rush University, including the ‘Anatomy Escape Room’ and ‘Who am I?’. To make it easier for viewers to implement their own virtual escape rooms, they provided a list of tools and provided an extensive list of other potential examples that could be used in the medical education setting. Lastly, they shared with us links to escape room instructor guides that can be used by the audience as inspiration to build their own educational escape rooms.

After the conclusion of the presentation, the audience had the chance to ask questions from Drs. Beresheim and Wilson. Questions that were discussed included, “Would you consider running a step-by-step course in the future where participants can construct their own escape room games?”, “Do students have a preference between in-person and virtual?”, followed by an ensuing discussion about the use of distractors in medical education escape room games.