P3.236: Cracking the confidence code: Comparing the impact of educational escape rooms and traditional teaching on pediatric residents

Background: Game-based learning (GBL) is increasingly utilized in medical education to boost learner engagement and motivation. Escape Rooms have recently been adapted as a novel form of GBL. Although emerging evidence supports the acceptability and feasibility of educational Escape Rooms among learners in medicine, few studies have examined the effectiveness of escape rooms compared to traditional teaching methods such as lectures or case-based discussions. The objective of this study was to compare the impact of educational Escape Rooms on learner self-assessed confidence as compared to traditional teaching modalities.

Methods: Three educational Escape Rooms (one on Nutrition and two on Infectious Diseases) were incorporated as a learning activity into a single pediatric residency program’s Academic Half Day (AHD) curriculum during the 2024-2025 academic year. Each AHD consists of a 3-hour block conference and includes Power Point lectures and case-based small group discussion. Electronic surveys were administered immediately before and one-month after AHD and assessed confidence in applying the knowledge reviewed in each learning modality on a 5-point scale (1=very unconfident; 5=very confident). Residents who did not participate in the AHD were surveyed at the same time to serve as controls. All participating residents were given gift card incentives. Only records with completed pre- and post-surveys were included in analysis. Two-way repeated measures ANOVA was used to assess change in confidence for individual sessions. T-test was used to assess overall impact of attendance on confidence and Dunn’s multiple comparison was used to compare combined data across teaching methods.

Results: Across all three AHD sessions, there were 88 residents in attendance and 48 records with completed pre- and post-surveys. Nineteen residents served as controls. Self-assessed confidence in each topic area increased over time between pre- and post-surveys in both residents who attended and did not attend AHD; however, with all sessions combined attendance had a statistically significant impact on increased confidence (p < 0.01)(Figure 1). As shown in Figure 2, compared to Power Point lectures, use of Escape Rooms demonstrated a greater increase in confidence (p < 0.05). Change in confidence levels was similar when comparing Escape Rooms to small group case-based discussions and small group to lectures.

Conclusion: Escape Rooms were more effective at increasing learner confidence than lectures but were comparable to small group discussions. Attending the AHD sessions featuring Escape Rooms improved confidence among pediatric residents compared to their non-participating peers. Further studies are needed to assess effectiveness at knowledge acquisition and retention in comparison to traditional methods as well as to understand the reasons behind the differences.