The design, implementation and evaluation of an Escape-Room as a form of game-based learning in medical education.

Abstract

Introduction: The aim of this study was to explore game-based learning in a novel, immersive, physical learning environment. We used the concept of the Escape Room, a popular hobby activity in Hong Kong in which a team of participants have to solve a series of puzzles to escape a locked room. Such activities adopt a team-based, discursive and problem-orientated approach to learning, mirroring the type of learning environment aspired to in medical education settings. Methods: The educational Escape-room was created using a cardiovascular syllabus, focussing on anatomy, physiology and pharmacology of the Medicine Year 2 cardiovascular block. A series of 8 challenges were devised, to be completed within a 45 minute timeframe by groups of 6 students in Year 2 the Medicine programme at the University of Hong Kong. Pedagogical design was based on game-based learning principles, and learning processes were anticipated to occur via interactive problem-based group discussion of the clues within the room. Participants were recruited via email and social media to participate on a voluntary basis. Data collection: Post-experience evaluation surveys were undertaken by all participants. In each group, a student also wore the chest-mounted camera to allow their actions to be recorded. A GoPro Hero 4 micro-camera weighing 88 grams was worn via a lightweight chest-mount. The wide-angle setting was employed to capture the visual maximum information from the student perspective, and audio data was also recorded by the device. Data Analysis : The videos themselves were entered into qualitative data analysis software (NVivo version 10, QSR) for analysis. Video was watched independently by two researchers and individual dialogue, actions or sequences of actions were open-coded using the grounded theory framework, followed by grouping into broad themes and subsequent refinement following reconciliation of differences. Results: One hundred and fifty one participants volunteered for the study (80 Female, 71 Male), representing 71.9% of the total student cohort. 8 hours and 41 minutes of video recording footage was obtained. Survey data revealed a high level of student engagement and self-reported improvement in problem solving and data interpretation. Qualitative analysis of video data demonstrated three main themes of learning behaviours: Cognitive engagement, metacognitive activity and positive collaboration. Conclusion: Within the Escape-Room environment, learning processes took place via group-based discussion of the clues within the room, and took an interactive, problem-based approach. Both predicted and un-predicated learning behaviours were observed, including reflective and metacognitive processes. Overall, the academic escape chamber was a well-received and pedagogically progressive teaching method. Main recommendations for discussion: 1.Escape-Room learning is an example of how popular games can be adapted to suit educational needs. Other games may provide similar, culturally and pedagogically appropriate avenues to explore game-based learning. 2.The use of wearable technology can enhance the collection of in-situ qualitative data from game-based learning environments.