Aim The emerging field of gamification, the addition of game play elements to non-game settings, is widely used in business and is increasingly being used in education. Successful methods have included live leader boards and a web-based game solving a protein folding conundrum. Method We designed an escape room (ER), incorporating gaming elements, focussing on communication in a surgical environment. A cross over study was delivered to 4th year medical students, comparing traditional simulation. The ER included logic puzzles, hidden clues, padlocked boxes, and surgical skills appropriate to their level. Self-reported engagement and teamwork were recorded, as was observed teamwork and communication skills. Results Self-reported engagement was very high for the students compared to more traditional simulation, including better understanding of effective communication strategies. The ER group were less likely to self-identify learning points but structured debrief mitigated this difference. Conclusions Gamification techniques can be integrated with good engagement and educational outcomes and should be considered as an adjunct to existing simulation strategy.

Aim Combining traditional simulation (TS) and the emerging field of gamification, to create medical Escape Rooms (ERS) has been used in Nursing to good results but is yet to be widely adopted in medical education. We conducted a pilot study to create ERS for undergraduates to assess their educational value. Method Existing Simulation themes of sepsis, post-operative bleeding, trauma, burns and communication in the theatre environment were developed into Escape Rooms by a multidisciplinary team. A cross over study for 4th year students was carried out. Questionnaires were used to evaluate the experience, learning assessed by pre and post quiz and observational tools for teamwork, communication and leadership were utilised. Results Qualitative data demonstrated overall good feedback on enjoyment an engagement. Quantitative data collected as pre- and post-exposure learning demonstrated equivocal benefit. Self-assessed teamwork showed equal in all domains and improved in contribution of knowledge and maintaining team focus on the ER group. Conclusions Participants find ER enjoyable have similar educational benefits of traditional simulation with the benefits on enhancing non-technical skills amongst a novice group. Escape rooms may be useful as an adjunct to TS particularly at developing non-technical skills.

Aim Escape rooms are an exciting way to learn through team-based challenges, particularly lending themselves to practical clinical skills. We sought to understand if escape rooms are beneficial for teaching urethral catheterisation to medical students. Method 12 third year medical students were given an initial knowledge assessment, before completing the escape room in groups of three. The room consisted of a number of tasks including labelling anatomy, checking patient details, and gathering equipment, and culminated in successfully catheterising a model. On completion they were given a post escape room knowledge assessment, which was repeated two weeks later to assess retention. This was compared to a control group undertaking a traditional teaching method. Results Initially, on a Likert scale of 1–5, 69% (n=9) stated that they were a 1 for confidence in performing a urethral catheterisation. After the escape room, all students recorded a 3 or 4, and two weeks later confidence remained at an average of 3 (n=8). 34.6% of questions were answered correctly in the pre assessment, improving to 90% at the post assessment, and two weeks later remained high at 84.1%. Conclusions Students' knowledge of urethral catheters significantly improved following the escape room, mirrored by their increase in confidence. Despite having never observed or inserted a urethral catheter, all groups successfully catheterised the model, and found the active learning process more engaging.