Unlocking Knowledge: Designing an Infectious Diseases-themed Escape Room for Medical Student and Resident Education

Abstract Background Infectious diseases (ID) education faces challenges with learner engagement, confidence, and specialty recruitment. Game-based learning, including educational escape rooms, offers an innovative strategy to increase engagement while reinforcing clinically relevant concepts. We designed an ID-themed escape room integrated into monthly clinical rotation curriculum for medical students and internal medicine residents. Methods General and targeted needs assessment informed eight learning objectives addressing board-relevant topics and common clinical errors: isolation precautions, zoonoses, empiric antimicrobial selection, laboratory safety, organism identification, molecular diagnostic interpretation, sexually transmitted infections, and MRSA-active antimicrobials. The physical outbreak-themed escape room used a hybrid puzzle structure with eight objective-aligned puzzles. Pilot testing by ID faculty, fellows, and medical students informed clarity, flow, and timing. Learners completed post-activity Likert-scale surveys assessing engagement, enjoyment, confidence, and perceived educational value. Results The escape room was implemented in April 2024. Twenty-five learners completed the post-activity survey. All participants agreed or strongly agreed that the activity was engaging, fun, enjoyable, and that they would like to participate in similar educational activities in the future. Most learners agreed or strongly agreed that the activity improved understanding, was a valuable addition to their learning experience, and increased confidence. Conclusions This ID-themed escape room provided an engaging, learner-centered approach to reinforcing clinical reasoning, antimicrobial decision-making, and infectious diseases concepts. Intentional alignment of learning objectives with puzzle design offers a reproducible roadmap for educators seeking to integrate escape rooms into clinical curricula. Future work should evaluate knowledge acquisition, scalability, sustainability, and effects on interest in ID careers.