Design, implementation, and evaluation of an educational escape room for critical care learning among emergency medicine residents

Background Traditional teaching methods often fail to adequately prepare emergency medicine (EM) residents for high-stakes critical care scenarios. Although gamified escape rooms show promise as active learning strategies, research has primarily focused on undergraduate learners. This study aimed to design, implement, and evaluate the feasibility, acceptability, and perceived learning associated with a theory-informed educational escape room focused on critical care concepts. Methods This study was conducted at a medical Skills Laboratory (Tehran University of Medical Sciences) among EM residents with > 6 months of clinical experience. A theory-informed educational escape room was designed by a multidisciplinary team, integrating clinical scenarios, puzzles, and ACGME competencies. The intervention included the escape room simulation followed by a structured three-phase debriefing (reactions, scenario analysis, and summary). Data were collected to evaluate participants’ satisfaction with the educational escape room experience and their perceptions of learning. Results A structured, multistep process led to the development of an educational escape room for EM residents, comprising five scenario-based challenges aligned with core competencies in resuscitation, airway management, trauma management, anaphylaxis, and poisoning. Of 24 eligible residents, 9 (37.5%) volunteered to participate; 3 participated in the pilot session and 6 completed the final intervention. The intervention was successfully implemented in this small volunteer sample following pilot testing and subsequent refinements. In the final intervention group, high participant satisfaction was observed, with an overall mean ± SD score of 4.35 ± 0.41, including 4.42 ± 0.51 for the debriefing session, 4.23 ± 0.44 for the quality of the educational escape room and 4.5 ± 0.45 for alignment with learners’ needs. Perceived learning was also rated favorably, with a mean ± SD score of 4.30 ± 0.53 in the final intervention group. Conclusion This pilot evaluation suggests that a structured, scenario-based educational escape room can be implemented in a small volunteer sample of EM residents and was well received by participants. Participants reported high satisfaction with the escape room experience and favorable perceptions of learning.