Virtual escape rooms in anatomy education: case studies from two institutions

Virtual escape rooms (ERs) require learners to solve puzzles and answer riddles while trying to "escape" a digital room. Although the educational merit of such gamified learning activities continues to be realized, guides on the development of ERs are lacking, as well as student perceptions on how, if, and where they should be integrated into medical curricula. Therefore, the aim of this study was to describe the experiences of building anatomy-themed virtual ERs of differing formats at two separate institutions, Queen's University Belfast (QUB) and Edward Via College of Osteopathic Medicine (VCOM), focusing on abdominal and upper limb anatomy, respectively. Google Workspace applications served as the primary platform. Three-dimensional (3-D) models were built with photogrammetry techniques or Virtual Human Dissector software (www.toltech.net) and integrated into the ER. Of 69 students and staff invited at QUB, 9 (13%) participated in the in-person virtual ER in teams of two or three (7 medical students, 2 anatomy instructors). Of 27 VCOM medical students invited, 8 (30%) agreed to participate and individually completed VCOM's virtual ER remotely. Anonymous surveys and a focus group revealed the ERs to be enjoyable and engaging and that they encouraged participants to think about material in a new way while helping them to identify knowledge gaps. Strengths and weaknesses of different designs (linear vs. nonlinear), delivery methods (in person vs. remote), and grouping of participants (team based vs. individual) were realized and discussed, revealing opportunities for optimizing the experience. Future studies would benefit from increasing sample sizes to assess the learning gain of such activities.<b>NEW & NOTEWORTHY</b> Virtual escape rooms (ERs) offer an innovative way to expose students to educational material in a creative, engaging way, particularly when they incorporate three-dimensional (3-D) models. Activities can be readily built with Google Workspace. Offering this activity to teams in a physical setting may promote collaboration and maximize the educational utility, whereas having learners complete it remotely on an individual basis may be more convenient, allowing them to fit it in their study schedule at their own convenience.