2025 Southeastern Residency Conference

Title: Development and Implementation of a Web-based Escape Room with Embedded Principles of Pharmacist Independent Prescribing

Authors: Christy Sherrill, Haley Simkins, Meg Parmelee

Objective: The primary objective of this pilot study is to assess change in pre/post acceptance and knowledge of ambulatory care and pharmacist prescribing, as well as diabetes-related knowledge following educational intervention utilizing a web-based escape room format. 

Background: As the plain of education advances, there arises an increased need for the development of new and adaptable teaching strategies to enhance learning outcomes across a variety of platforms that speak to all learning styles and settings. In this current era, we have many advances in technology to employ, including the idea of gamification, which has been identified as a creative strategy to give learners real-life, hands-on experience in a virtual platform. Over recent years, the utilization of the virtual escape room has become a popular educational tool in medical education. In this research study, ambulatory care and pharmacist prescribing are the two key content focuses, and students will be exposed to these concepts through a web-based escape room utilizing diabetes as the clinical topic. This escape room will teach ambulatory care and pharmacist prescribing processes initially in the context of diabetes, with the hopes to expand to other disease states as a “plug and play” option.

Methods: The primary research aims of this study are to assess the impact that simulation using gamification has on student pharmacists’ acceptability and knowledge of the pharmacist’s scope of practice, to investigate the effect of simulation using gamification on student pharmacists’ diabetes-related knowledge and confidence, and to analyze student pharmacists’ perceptions of simulation using gamification for educational purposes. To accomplish these aims, after initial focus group and beta testing, a finalized escape room was piloted among pharmacy students from varying years of study completing didactic coursework on the University of North Carolina Asheville campus and experiential education in the Asheville area. Students completed a pre-survey, then conducted the escape room in 30-minute time slot, followed by a debrief and 10 minute immediate-post survey. Results of the pre and post surveys were analyzed for quantitative and qualitative data. The pre-survey and post-survey contained a 12-item knowledge assessment on diabetes management principles and a 12-item confidence assessment on the principles of independent prescribing. Results were compared pre- and post-escape room activity.

Results:  After completing the activity, average scores on the diabetes-related knowledge assessment improved from 76.75% to 89.82%. This was a significant improvement as evidenced by a p-value <0.05 (two-tailed paired t-test). Four questions performed the same pre and post activity. Seven questions performed better post-activity. One question performed worse, with only 4 students answering correctly. Participants answered 7 out of 12 questions 100% correctly post-activity. All questions were answered correctly by at least 80% of students, aside from Q2 as an outlier. In regard to confidence levels, students saw improvement in confidence level on every one of the 12 confidence questions.

Conclusions: Participants in this pilot study saw statistically significant improvement in overall knowledge of diabetes management principles and increases in confidence with regards to principles of independent prescribing immediately after completion of the escape room. Participants overall were happy with the virtual escape room as a fun and more engaging learning platform, citing room for improvement in the usability of the interface, as well as future considerations for expanding the potential uses of the platform.