by Natalie Kern, PharmD, PGY1 Community Pharmacy Practice Resident, Walgreens Pharmacy
In my experience as a student, educational games merely included flash cards for memorizing drug names and the ever-famous Jeopardy test review before a big exam. A recent publication caught my eye. The instructors were using an “escape room” for teaching and learning purposes. The notion of participating in an escape room in an academic setting seemed exhilarating but, frankly, unfathomable. An escape room is a “live-action team-based game where players discover clues, solve puzzles, and accomplish tasks in one or more rooms in order to accomplish specific goals in a limited amount of time.”1 On any given Saturday night, you can find friends lining up to embark on an escape room adventure. No matter the age, people seem to love the interactive mystery of the escape room. Escape rooms are a team-building adventure game, where players are locked in a room to gather clues, discover hidden objects, and solve riddles in order to escape. Could such a collaborative, task-centered, time-based activity be used to promote student engagement in the classroom?
Many educators struggle to effectively maintain the attention and interest of millennial students in traditional classrooms. Teaching methods such as problem-based learning, flipped classrooms, case-based learning, and gaming seek to promote engagement. “Escape room”- like activities are a new form of instructional gaming or gamification. Clues and puzzles provided in the activity relate to the specific learning objectives of the course. While health professional programs in medicine, nursing, and pharmacy have documented adaptations of educational escape rooms, all describe their success in small groups of students.
The University of Kentucky College of Pharmacy adapted the popular phenomenon into its five-credit required Pharmacy Management course when third-year student pharmacists expressed disinterest in the course.2 Students felt that the course was irrelevant to their future careers. The course instructors decided to adapt by providing students with engaging real-life applications. They developed a blended online/ offline escape room activity to help students review basic human resource laws and the hiring process. The course designers built an educational escape room for a class of over 100 student pharmacists. Students were not required to escape an actual room; instead, they completed paper and electronic puzzles and riddles that lead to a series of clues that would help them unlock a box with a combination lock.
One week before participating in the educational escape room, the instructors gave a two-hour lecture on employment law and explained the hiring process. The students were given all the information that they needed to successfully complete the “escape room.” Therefore, the objective of the activity was to reinforce the fundamentals of human resource principles discussed in the lecture. The “escape room” was designed to be completed in a one-hour class period, allowing 5 minutes for instruction, 45-minutes for the students to solve the escape puzzles, and 10 minutes for debriefing. Using an online learning management system, students were organized into twenty-four groups consisting of five to six learners. On the day of the activity, groups met face-to-face in the classroom auditorium. Two-course instructors and a PGY1 resident facilitated the activity by reviewing the rules and directions of the game and a timer was set for 45 minutes. Each team was required to complete 10 puzzles that would enable them to select the best candidate for a new pharmacist’s position. A four-digit number was embedded within the best candidate's resume; this would be used to unlock a box at the front of the auditorium. If any team was unable to advance to the next puzzle, they could ask for a hint from an instructor. However, the team would be given a one-minute penalty. The three teams who finished the fastest received bonus points for the management course. All participants were asked to complete an anonymous survey about their experience. One hundred and thirty-nine responses were recorded.
Overall, the students' perceptions of the escape room activity were positive. Ninety-one percent of students reported more engagement in the material compared to the typical classroom lecture. Over 80% of participants felt more involved in the subject matter when compared to the lecture. The students also agreed that teamwork played an important part in successfully completing the activity. From the instructors’ perspective, logistics were complex and a lot of planning was required for the success of this large-scale escaped room.
Thinking of implementing an educational escape room in your course? While creating puzzles and clues are not difficult, ensuring that students are engaged in the material rather than merely playing a game is a key to the instructional design. This challenges educators to develop clear objectives. Does Bloom’s Taxonomy ring a bell? It is important to identify the cognitive domains the escape room is intended to achieve when writing the objectives.3 In reflecting on the potential educational outcomes of an escape room, students are challenged to think critically, transitioning from understanding lecture material to applying and analyzing the information. A course designer needs to consider the class and room size as well as logistics when planning the escape room. Students can be placed into small groups in class or online based on the preference of the course designer and space limitations. The instructor will need to create a set of activities that encourage the students to problem solve together and to arrive at a specific answer. A correct answer reveals a new clue and a new activity or challenge. When facilitating an escape room for a large group of students, online problem-solving activities are not limited by space and can save money on supplies. Be mindful of the time needed for the instructor to create and the students to participate in the escape room. According to Cain, it took 20 hours to design the puzzles and clues for the activity. Lastly, consider pilot testing the activity on a small group of students to estimate the time needed to complete the escape room. This will also help identify potential problems.1
After listening to more than my fair share of lectures, the classroom feels more like a room that I’d like to escape rather than an engaging space for intellectual growth. New methods for gamification create an innovative spin on the beloved “group project” by facilitating collaborative efforts of all team members to reach the finish line. Escape room-like activities require effective communication, teamwork, and delegation. These are skills needed to be an effective member of a healthcare team. Escape rooms are a great way to challenge students to be collaborative problem-solvers.
- Peeking behind the locked door: A survey of escape room facilities. Self-published 2015. White Paper available online at:http://scottnicholson.com/pubs/erfacwhite.pdf.
- Cain J. Exploratory implementation of a blended format escape room in a large enrollment pharmacy management class. Currents in Pharmacy Teaching and Learning. 2019 Jan;11(1):44-50. doi: 10.1016/j.cptl.2018.09.010. Epub 2018 Oct 3.
- Poirier T, Crouch M, MacKinnon G, Mehvar R, Monk-Tutor M; American Association of Colleges of Pharmacy.. Updated guidelines for manuscripts describing instructional design and assessment: the IDEAS format. Am J Pharm Educ. 2009 May 27;73(3): Article 55.