Escape Room Versus Traditional Simulation: A Comparative Study of the A-E (Airway, Breathing, Circulation, Disability, Exposure) Assessment in Undergraduate Medical Training

Background The A-E (Airway, Breathing, Circulation, Disability, Exposure) assessment is a systematic approach used for the primary assessment of critically injured patients, and is often taught through simulation-based learning methods. The introduction of new educational methods, such as escape rooms, may be used to enhance engagement, teamwork, and educational value. Objectives The objective of this study is to compare the effectiveness of the conventional A-E simulation format with an escape room-style A-E simulation format in enhancing medical students' engagement, teamwork, and educational value. Methods We conducted a qualitative study involving 19 undergraduate medical students, with nine allocated to the traditional simulation group and 10 to the escape room simulation group. The participants from the traditional simulation group and the escape room simulation group were further divided into three subgroups, with each group being assigned one of the following clinical scenarios: opioid overdose, sepsis, and upper gastrointestinal bleeding. Pre- and post-session questionnaires were used to assess engagement, teamwork, and educational value. Results Thematic analysis revealed four key themes: engagement and realism, teamwork and communication, clinical reasoning, and knowledge retention and enhanced learning. Escape room participants found the escape-style clinical scenarios to be more immersive and enjoyable in comparison to the traditional simulation group. The escape room-style simulation showed overall favourable reviews across the four key themes identified. Conclusion Escape room-style simulation is a highly engaging and interactive alternative to traditional A-E simulation in undergraduate medical education. It promotes learner engagement, teamwork, and clinical reasoning while maintaining educational rigour. Though more resource-intensive to develop, it holds promise as an effective adjunct for teaching A-E assessments.