Presentations

Abstract

Introduction:

The popularity of escape rooms as a teaching tool in medical education has grown in recent years. Escape room games have been shown to increase knowledge, self-confidence, and long-term retention. To determine if a virtual escape room could serve as an effective exam review, we implemented a cranial nerve escape room in a gross anatomy course with health professions students.

Methods:

One hundred thirty-nine Pathologist Assistant, Surgical Assistant, and Physician Assistant students enrolled in the Health Professions Anatomy course at Eastern Virginia Medical school participated in a pre-post single-arm pilot as a required, ungraded portion of the course. Students completed a pre-activity competency test which comprised 10 multiple choice questions on relevant clinical cases. Next students worked in groups of 4-6 students to complete a virtual escape room built in Articulate Storyline. The concept was students were trapped within the brain and had to determine the correct cranial nerve exit. To do so, students had to solve various puzzles (crosswords, drag and drops, hot spots, ordering, etc), each when answered correctly gave them a clue to narrow down the correct exit. When they determined the correct exit path, they were instructed to text the answer to the instructor. The activity took 36-67 minutes for teams to complete. Following completion of the activity, students repeated a 10 question knowledge quiz and a survey that explored if the activity was useful, if working in teams was effective, and if the activity in general was successful in helping to learn the material. Data from the surveys were downloaded and analyzed using Microsoft Excel. The data from pre-tests and post-tests with identical questions were compared using an unpaired t-test with a p-value of < 0.01 being considered significant.

Results:

One hundred thirty-nine students completed the pre-test (100%), one hundred twenty-seven students (91.4%) completed the post-test, and ninety-five (68.3%) students completed the post-survey. When comparing the pre-activity and post-activity competency tests, scores improved for all questions with score increases ranging from 8.7% to 29.2%. There was a significant difference (p<0.01) in the overall pre-test score of 55.08% compared to the post-test score of 70.17%. On the post-activity survey, 82.1% agreed or strongly agreed that they found the activity to be a productive use of time. 90.5% thought the activity was an effective team building activity. 96.8% thought the activity encouraged the use of communication and collaborative skills. 66.32% felt more confident about the material after the activity. 92.6% agreed or strongly agreed that it helped expose their gaps in knowledge. And 75.8% said that they plan to play the escape room again as a review for their exam.

Conclusion:

The increase in scores on all questions on the post-activity competency test is a strong indicator that the activity was effective at enhancing students' knowledge of the material. In addition, the majority of students found the activity to be a productive use of time, helpful with team building, and allowed them to feel more confident about the material. The use of an escape room tailored specifically to the curriculum of a graduate-level anatomy course was highly effective as a teaching tool.