The primary goal of this meta-analysis is to explore the five factors of knowledge, teamwork, learning satisfaction, anxiety, and interprofessional ability to determine the value of escape rooms in medical education. Up to January 2023, we searched ScienceDirect, Scopus, PubMed, Embase, Web of Science, CNKI, and the Cochrane Library for pertinent works in either English or Chinese. The Risk of Bias 2 (RoB 2) tool and Newcastle–Ottawa Scale (NOS) were used to assess the quality of studies. Subgroup and sensitivity analyses were used to assess statistical heterogeneity, and I2 was used to measure it. Overall, escape rooms had a more significant positive effect than traditional learning on knowledge (standardized mean difference [SMD]: 0.84; 95% confidence interval [CI]: 0.36–1.33), teamwork (SMD: 4.91; 95% CI: 4.58–5.24), learning satisfaction (MD: 0.36; 95% CI: 0.08–0.64), and interprofessional ability (SMD: 1.04, 95% CI: 0.81–1.27). Moreover, the impact of escape rooms on anxiety also had significant effects (SMD: −8.23, 95% CI: −11.64 to −4.82). Escape rooms affect medical students’ knowledge, teamwork, learning satisfaction, interprofessional ability, and anxiety. The findings of this study can be used as evidence that escape rooms is a more effective method than traditional teaching for improving active learning.
Get full access to this article
View all access options for this article.
References
1.
JallaA, SturgesJ, LeesJ. Integration of Educational Technology. Surg Clin North Am, 2021; 101(4):693–701; doi: 10.1016/j.suc.2021.05.014
2.
KapralosB, FisherS, ClarksonJ, et al.A course on serious game design and development using an online problem-based learning approach. Interactive Technol Smart Educ, 2015; 12(2):116–136; doi: 10.1108/ITSE-10-2014-0033
3.
XuM, LuoY, ZhangY, et al.Game-based learning in medical education. Front Public Health, 2023; 11:1113682; doi: 10.3389/fpubh.2023.1113682
BoadaI, Rodriguez-BenitezA, Garcia-GonzalezJM, et al.Using a serious game to complement CPR instruction in a nurse faculty. Comput Methods Programs Biomed, 2015; 122(2):282–291; doi: 10.1016/j.cmpb.2015.08.006
6.
TanAJQ, LeeCCS, LinPY, et al.Designing and evaluating the effectiveness of a serious game for safe administration of blood transfusion: A randomized controlled trial. Nurse Educ Today, 2017; 55:38–44; doi: 10.1016/j.nedt.2017.04.027
7.
LamJT, GutierrezMA, GoadJA, et al.Use of virtual games for interactive learning in a pharmacy curriculum. Curr Pharm Teach Learn, 2019; 11(1):51–57; doi: 10.1016/j.cptl.2018.09.012
8.
ChenTS, HsiehPL, TungCC, et al.Evaluation of registered nurses’ interprofessional emergency care competence through the gamification of cardiopulmonary resuscitation training: A cross-sectional study. BMC Med Educ, 2023; 23(1):359; doi: 10.1186/s12909-023-04332-y
9.
GauthierA, KatoPM, BulKC, et al.Board games for health: A systematic literature review and meta-analysis. Games Health J, 2019; 8(2):85–100; doi: 10.1089/g4h.2018.0017
10.
MoffettJ, CassidyD, CollinsN, et al.Exploring medical students’ learning around uncertainty management using a digital educational escape room: A design-based research approach. Perspect Med Educ, 2023; 12(1):86–98; doi: 10.5334/pme.844
11.
PinerosN, TenaillonK, MarinJ, et al.Using gamification to improve engagement and learning outcomes in medical microbiology: The case study of ‘BacteriaGame’. FEMS Microbiol Lett, 2023; 370:fnad034; doi: 10.1093/femsle/fnad034
12.
GuckianJ, SridharA, MeggittS. Exploring the perspectives of dermatology undergraduates with an escape room game. Clin Exp Dermatol, 2020; 45(2):153–158; doi: 10.1111/ced.14039
LeppGA, FierkeKK, FriedrichC, et al.How intention/reflection fosters student learning in an interprofessional experiential escape room activity. J Interprof Educ Pract, 2023; 30:100589; doi: 10.1016/j.xjep.2022.100589
15.
QuekLH, TanAJQ, SimMJJ, et al.Educational escape rooms for healthcare students: A systematic review. Nurse Educ Today, 2024; 132:106004; doi: 10.1016/j.nedt.2023.106004
16.
HintzeTD, SamuelN, BraatenB. A systematic review of escape room gaming in pharmacy education. Am J Pharm Educ, 2023; 87(5):100048; doi: 10.1016/j.ajpe.2022.09.007
17.
González-de la TorreH, Hernández-De LuisM-N, Mies-PadillaS, et al.Effectiveness of “Escape Room” Educational Technology in Nurses’ Education: A Systematic Review. Nurs Rep, 2024; 14(2):1193–1211; doi: 10.3390/nursrep14020091
18.
PageMJ, McKenzieJE, BossuytPM, et al.The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Bmj, 2021; 372:n71; doi: 10.1136/bmj.n71
19.
Amir-BehghadamiM, JanatiA. Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emerg Med J, 2020; 37(6):387; doi: 10.1136/emermed-2020-209567
20.
SterneJA, SavovićJ, PageMJ, et al.RoB 2: A revised tool for assessing risk of bias in randomised trials. Bmj, 2019; 366:l4898; doi: 10.1136/bmj.l4898
21.
WellsGA, SheaB, O’ConnellD, et al.The Newcastle-Ottawa Scale (NOS) For Assessing The Quality Of Nonrandomised Studies In Meta-Analyses. Oxford University Press, Oxford, UK. 2000.
22.
FuscoNM, Foltz-RamosK, OhtakePJ. An Interprofessional Escape Room Experience to Improve Knowledge and Collaboration Among Health Professions Students. Am J Pharm Educ, 2022; 86(9):ajpe8823; doi: 10.5688/ajpe8823
23.
BujandaA, BujandaE. DIABESCAPE: An innovative educational project on diabetes. Endocrinol Diabetes Nutr (Engl Ed), 2022; 69(6):392–400; doi: 10.1016/j.endien.2022.06.007
24.
Foltz-RamosK, FuscoNM, PaigeJB. Saving patient x: A quasi-experimental study of teamwork and performance in simulation following an interprofessional escape room. J Interprof Care, 2021; 15:1–8; doi: 10.1080/13561820.2021.1874316
25.
Gutiérrez-PuertasL, Márquez-HernándezVV, Román-LópezP, et al.Escape rooms as a clinical evaluation method for nursing students. Clin Simul Nurs, 2020; 49:73–80; doi: 10.1016/j.ecns.2020.05.010
26.
Molina-TorresG, Sandoval-HernándezI, Ropero-PadillaC, et al.Escape Room vs. Traditional Assessment in Physiotherapy Students’ anxiety, stress and gaming experience: A comparative study. Int J Environ Res Public Health, 2021; 18(23):12778; doi: 10.3390/ijerph182312778
27.
Rodríguez-FerrerJ, Manzano-LeónA, Fernández-JiménezC, et al.The use of digital escape rooms in nursing education. BMC Med Educ, 2022; 22(1):901; doi: 10.1186/s12909-022-03879-6
28.
BakerCM, CrabtreeG, AndersonK. Student pharmacist perceptions of learning after strengths-based leadership skills lab and escape room in pharmacy practice skills laboratory. Curr Pharm Teach Learn, 2020; 12(6):724–727; doi: 10.1016/j.cptl.2020.01.021
29.
BarrickmanA, BaughG, PurnellK, et al.Development and implementation of a virtual interprofessional escape room to reinforce tobacco cessation concepts. J Interprof Educ Pract, 2022; 27:100511; doi: 10.1016/j.xjep.2022.100511
30.
MillsapsER, SwihartAK, LemarHB. Time is brain: Utilizing escape rooms as an alternative educational assignment in undergraduate nursing education. Teach Learn Nurs, 2022; 17(3):323–327.
31.
ReedJM, FerdigRE. Gaming and anxiety in the nursing simulation lab: A pilot study of an escape room. J Prof Nurs, 2021; 37(2):298–305; doi: 10.1016/j.profnurs.2021.01.006
32.
WettergreenSA, StewartMP, HuntsberryAM. Evaluation of an escape room approach to interprofessional education and the opioid crisis. Curr Pharm Teach Learn, 2022; 14(3):387–392; doi: 10.1016/j.cptl.2022.01.021
33.
WynnL. An escape room simulation focused on renal-impairment for prelicensure nursing students. Teach Learn Nurs, 2021; 16(1):95–99; doi: 10.1016/j.teln.2020.09.006
34.
PalasikBN, ChoHJ, AtandaA, et al.An escape room activity to teach transitions-of-care: Student perceptions and lessons learned. Pharm Educ, 2022; 22(1); doi: 10.46542/pe.2022.221.664671
35.
LiY, GongC, TanL, et al.Application of escape room teaching model in clinical practice teaching in department of cardiovascular medicine for baccalaureate nursing students. J Nurs Sci, 2022; 37(02):56–59.
36.
KutzinJM. Escape the room: Innovative approaches to interprofessional education. J Nurs Educ, 2019; 58(8):474–480; doi: 10.3928/01484834-20190719-07
37.
WilsonM, GerberLE. How generational theory can improve teaching: Strategies for working with the millennials. Curr Teach Learn, 2008; 1(1):29–44.
38.
TurnerA, TichterAM, PillowMT. Let’s escape didactics: Virtual escape room as a didactic modality in residency. J Educ Teach Emerg Med, 2021; 6(2):SG46–SG56; doi: 10.21980/J8CH2X
39.
RutledgeC, WalshCM, SwingerN, et al.Gamification in action: Theoretical and practical considerations for medical educators. Acad Med, 2018; 93(7):1014–1020; doi: 10.1097/ACM.0000000000002183
40.
BuchnerJ, RüterM, KerresM. Learning with a digital escape room game: Before or after instruction? Res Pract Technol Enhanc Learn, 2022; 17(1):10; doi: 10.1186/s41039-022-00187-x
41.
BarrickmanA, McMillanA, Gálvez-PeraltaM, et al.Development and assessment of integrated virtual escape rooms to reinforce cardiology content and skills. Am J Pharm Educ, 2023; 87(3):ajpe8899; doi: 10.5688/ajpe8899
42.
GuckianJ, EvesonL, MayH. The great escape? The rise of the escape room in medical education. Future Healthc J, 2020; 7(2):112–115; doi: 10.7861/fhj.2020-0032
43.
Antón-SolanasI, Rodriguez-RocaB, Urcola-PardoF, et al.An evaluation of undergraduate student nurses’ gameful experience whilst playing a digital escape room as part of a FIRST year module: A cross-sectional study. Nurse Educ Today, 2022; 118:105527; doi: 10.1016/j.nedt.2022.105527
44.
DavisK, LoH-y, LichliterR, et al.Twelve tips for creating an escape room activity for medical education. Med Teach, 2022; 44(4):366–371; doi: 10.1080/0142159X.2021.1909715
45.
VidenovikM, VoldT, DimovaG, et al.Migration of an Escape room–style educational game to an online environment: Design Thinking methodology. JMIR Serious Games, 2022; 10(3):e32095; doi: 10.2196/32095
46.
HawkinsJE, WilesLL, TremblayB, et al.Behind the scenes of an educational escape room. Am J Nurs, 2020; 120(10):50–56; doi: 10.1097/01.NAJ.0000718636.68938.bb
47.
ShahAS, PittM, NortonL. ESCAPE the Boring Lecture: Tips and Tricks on Building Puzzles for Medical Education Escape Rooms. J Med Educ Curric Dev, 2023; 10:23821205231211200; doi: 10.1177/23821205231211200
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
