Enhancing Medical Education: Small Group Teaching vs. Escape Room in Reproductive Health Training

Educational Context and Study Design

The small group class in Reproductive Endocrinology and Infertility (REI) was part of the undergraduate program for 5th-year medical students at the University of Oslo. Groups of 3-5 students were formed at the semester’s start and attended all teaching sessions together. This study was non-randomized and retrospective, comparing two methods: small group teaching and small group teaching paired with an escape room game. Ethical approval wasn’t required due to the anonymous nature of the study.

Small Group Class Activities

Students prepared for class by reviewing relevant materials on the REI website. The class commenced with clinical rounds where students shadowed a gynecologist for 2 hours in an outpatient clinic. Most students observed transvaginal ultrasound examinations and participated in early pregnancy consultations. Following the clinical rounds, students engaged in either traditional case discussions or escape room games over several semesters.

Escape Room Game Development

The escape room game was designed following a generic template, focusing on educational integration. The learning objectives included:

1. Understanding human conception and early pregnancy signs.
2. Performing ultrasound examinations on a mannequin.
3. Recognizing signs of intrauterine pregnancy and calculating gestational age.
4. Demonstrating professionalism during clinical exams.
5. Showing teamwork under time pressure.

Puzzles were created based on these objectives and were refined through trial sessions.

Implementation of the Escape Room

The escape room game utilized various props, including an ultrasound scanner, a mannequin, and a document safe for puzzles. The setup took place in a gynecological outpatient room, arranged carefully to facilitate gameplay. Students entered the room after receiving an introductory script and an envelope with game instructions. A countdown timer set to 30 minutes guided the game duration.

The game featured 8 puzzles, each interconnected and varying in complexity. Students had to measure fetal length, interpret patient histories, and operate the ultrasound scanner as part of the gameplay. If the group was stuck, hints were provided through a baby monitor. The game concluded after 30 minutes or once the group completed the challenges.

Student Feedback and Assessment

Students completed a questionnaire assessing their satisfaction, teamwork quality, knowledge gained, and areas for improvement. The feedback was anonymously gathered online. Quantitative data were analyzed using descriptive statistics, while qualitative responses were thematically analyzed.

Knowledge Assessment

All students took part in a plenary session focused on REI, which included a 20-question knowledge test. This test covered broad REI topics, not just those discussed in small group classes. Scores from students who had attended the small group class were compared to those who had not to evaluate the impact of the class on knowledge retention. Results were measured with Cohen’s d to express effect size.