The Impact of Educational Escape Rooms on Occupational Therapy Students
The Impact of Educational Escape Rooms on Occupational Therapy Students
Reghan Massie, Hailey Stufflet, Emily Suarez, Kyle Longhofer, Chia-Wei Fan
Department of Occupational Therapy, AdventHealth University
Abstract
Educational escape rooms have gained popularity as a gamified learning tool. This study examined the efficacy of escape rooms as a
teaching tool for Master of Occupational Therapy (MOT) and Occupational Therapy Assistant (OTA) students. Participants completed
the curriculum-based escape room activities and pre- and post-assessments were evaluated on knowledge retention, intraprofessional
collaboration, and critical thinking. Results showed that the escape room experience improved students’ knowledge retention and their
perception of critical thinking abilities, while findings on intraprofessional collaboration varied between MOT and OTA students.
Introduction
Escape rooms have emerged as a unique educational approach that combines gamified learning with team-based problem-solving
(Sánchez et al., 2022). These interactive experiences require participants to solve puzzles, communicate effectively, and collaborate
under time constraints to escape the locked room. Research suggested that gamified learning enhances student engagement and
knowledge retention, particularly when integrated into existing curricula (Fan, 2023; Moore & Campbell, 2021). This study aimed to
evaluate the effectiveness of the educational escape room for MOT and OTA students, focusing on its impact on knowledge retention,
intraprofessional collaboration, and active learning and critical thinking abilities.
Methods
A pre-experimental design was used. The escape room activity was mandatory and integrated into class time, while participation in the
pre- and post-assessments was voluntary. IRB approval was obtained, and participants signed the consent forms before enrollment.
Assessments
Students completed three assessments at two time points: two weeks before and immediately after the escape room activity.
Knowledge Assessment: A 20-item multiple-choice test developed by researchers to evaluate students’ understanding of targeted
clinical skills.
Self-assessment Scale on Active Learning and Critical Thinking (SSACT): A 14-item questionnaire measuring self-reported critical
thinking and problem-solving abilities (Khoiriyah et al., 2015).
Readiness for Interprofessional Learning Scale (RIPLS): A 19-item Likert-scale assessment assessing self-perceptions of teamwork and
collaboration (Binienda, 2015).
Escape Room Implementation
MOT and OTA students were randomly assigned into 12 teams, each consisting of 2–3 MOT students and 1–2 OTA students, to promote intraprofessional collaboration. The 1-hour escape room activity happened in a simulation lab, and it included ten puzzles and challenges directly tied to curriculum topics (Please refer to Fig. 1). Course instructors and investigators oversaw the session and provided hints as needed.
Figure 1. Flow Chart of Puzzles within
the Educational Escape Room
Data Analysis
Wilcoxon Signed Rank test was used for paired ordinal data. Demographics including age and gender were collected.
Results
Demographics
Participants included 48 students enrolled in the Clinical Skills course: 33 MOT students (69%) and 15 OTA students (31%) with an
average age of 23 (S.D. = 3.98 years). Approximately 90% were female.
Knowledge Retention
Post-assessment scores demonstrated a statistically significant increase in knowledge retention (p < .05). This improvement confirmed
that the escape room effectively reinforced curriculum content.
Critical Thinking and Problem-Solving
SSACT scores increased significantly (p < .05), indicating that students felt more confident in their ability to actively learn and thinkcritically after the gamified experience.
Intraprofessional Collaboration
RIPLS scores revealed mixed outcomes. Combined scores for MOT and OTA students showed no statistically significant improvement in
perceptions of collaboration. However, when analyzed separately, MOT students exhibited a positive shift in RIPLS scores (p < .05),
indicating improved perceptions on teamwork. In contrast, OTA students’ RIPLS scores showed a slight, though not statistically
significant, decrease of two points (p > .05), suggesting the experience might not effectively enhance their perceptions of
intraprofessional collaboration.
Discussion
These findings are consistent with existing literature on gamified learning, which emphasizes its benefits in enhancing student
engagement (Dugnol-Menéndez et al., 2021; Fan, 2023). The significant improvement in post-assessment knowledge scores
demonstrates the effectiveness of this approach in reinforcing students’ understanding of foundational skills. Additionally, the increase in
SSACT scores indicates that escape rooms enhance students’ confidence in active learning and critical thinking—essential skills for OT
practitioners tasked with managing complex patient needs and making informed decisions (Moore & Campbell, 2021). However, the
outcomes for intraprofessional collaboration were mixed. While MOT students showed improved perceptions of teamwork, OTA
students’ scores declined slightly, possibly due to variations in team dynamics or unclear role delineation during the activity. These
findings highlight the need for targeted strategies to enhance collaboration between MOT and OTA students (Dennehy, 2022).
Limitations and Future Research
This study had several limitations. Participation in the assessments was voluntary, which has potential selection bias. Additionally, the
small sample size limited the generalizability of findings. Future research could explore the impact of escape rooms in larger and more
diverse cohorts and investigate the reasons behind the differing collaboration outcomes for MOT and OTA students.
Implications for Practice
Educational escape rooms offer a practical and engaging way to develop these skills while reinforcing curriculum knowledge. The
findings of this study support the inclusion of gamified learning experiences in occupational therapy education, particularly for fostering
critical thinking and knowledge retention.
Conclusion
Educational escape rooms represent an innovative and effective teaching tool for occupational therapy programs. This study
demonstrated that escape rooms could enhance students’ knowledge retention, critical thinking, and perceptions of collaboration. By
embedding these experiences into curricula, educators can create engaging, hands-on learning opportunities that prepare students for
the demands of clinical practice.
References
Binienda, J. (2015). Critical synthesis package: Readiness for interprofessional learning scale (RIPLS). MedEd Portal.
https://www.mededportal.org/doi/10.15766/mep_2374-8265.10274
Dennehy, T. (2022). Intraprofessional collaboration in OT/OTA academia: Immersive innovations for skill building. Journal of
Occupational Therapy Education, 6 (2). https://doi.org/10.26681/jote.2022.060209
Dugnol-Menéndez, J., Jiménez-Arberas, E., Ruiz-Fernández, M. L., Fernández-Valera, D., Mok,
A., & Merayo-Lloves, J. (2021). A collaborative escape room as gamification strategy to
increase learning motivation and develop curricular skills of occupational therapy
students. BMC Medical Education, 21(1), Article 544.
https://doi.org/10.1186/s12909-021-02973-5
Fan, C.-W. (2023). Using escape rooms to promote active learning and intraprofessional collaboration in occupational therapy students:
A pilot study. Poster presented at the 106th American Occupational Therapy Association INSPIRE 2023 conference, Kansas City,
MO, April 20-23. https://doi.org/10.5014/ajot.2023.77S2-PO165
Khoiriyah, U., Roberts, C., Jorm, C., & Van der Vleuten, C. P. (2015). Enhancing students' learning in problem-based learning: Validation
of a self-assessment scale for active learning and critical thinking (SSACT). Biomedical Engineering Education, 15, Article 140.
https://doi.org/10.1186/s12909-015-0422-2
Moore, L., & Campbell, N. (2021). Effectiveness of an escape room for undergraduate interprofessional learning: A mixed methods
single group pre-post evaluation. BioMed Central Medical Education, 21, Article 220. https://doi.org/10.1186/s12909-021-02666-z
Sánchez, S., Lampropoulos, G., & López-Belmonte, J. (2022). Comparing gamification models in higher education using face-to-face
and virtual escape rooms. Journal of New Approaches in Educational Research, 11. https://doi.org/10.7821/naer.2022.7.1025