Escape to learn: the effectiveness of escape rooms for engagement and learning outcomes of undergraduate medical students. A randomised controlled trial

Escape rooms (ERs) are gaining popularity as innovative educational tool in health professions training. By presenting participants with a series of sequential challenges, ERs compel students to solve progressively complex problems, requiring collaboration and sharing of expertise, knowledge, and skills, and mimicking the teamwork and problem-solving abilities required in clinical practice.In this study, I designed an educational ER centred on neonatal care, where teams of medical students need to solve content-specific challenges to progress through the activity. These challenges simulated leadership and management hurdles commonly encountered in professional practice, while reinforcing academic knowledge covered in traditional teaching sessions.The primary aim of this research was to evaluate the effectiveness of ERs as educational tools for fourth-year medical students enrolled in a Paediatric course, specifically during their Neonatal rotation at the Rotunda Hospital. A randomised controlled trial (RCT) design was employed, comparing students' performance on Objective Structured Clinical Examinations (OSCEs) and Multiple- Choice Questions (MCQs) between those who participated in the ER and a control group. Additionally, a post-activity survey, based on a five-point Likert scale, was administered to gather feedback on students’ learning experiences. Although no significant differences were observed between the students that participated in the ER and the control groups in terms of OSCE and MCQ scores, survey responses revealed that the majority of students found the ER to be a valuable learning tool. Seventy-eight percent of participants indicated that they learned better in a game-based format and highlighted the benefits of teamwork and lateral thinking. Furthermore, all participants expressed a willingness to recommend the ER activity to their peers. Overall, although the quantitative performance data did not reveal statistically significant improvements in exam scores, the qualitative feedback reveals the potential of ERs as an effective educational tool for enhancing student engagement and perceived learning. These findings suggest that while ERs may not directly lead to a measurable difference in standardised assessments, they foster active, team-based learning, and enhance engagement, teamwork, critical thinking, and practical application of neonatal knowledge among medical students. This highlights the potential role of educational ERs in promoting soft skills training within healthcare education, warranting further exploration into their long-term educational benefits.