JMIR Publications

ABSTRACT

Background:

Educational escape rooms have gained increasing attention in medical education as immersive, game-based learning activities that promote engagement, collaboration, and active problem-solving. However, evidence remains limited regarding the specific experiential mechanisms that contribute to their perceived educational value, particularly when evaluated using validated instruments.

Objective:

This study aims to evaluate a student-designed medical escape room with digital components implemented for preclinical medical students and to examine how distinct dimensions of game-like (gameful) experience relate to learners’ perceptions of overall value and educational efficacy.

Methods:

A cross-sectional study was conducted among 144 preclinical medical students who participated in a medical escape room integrating foundational medical knowledge and basic clinical skills. Learner perceptions were assessed using the Diabetes Escape Room Perception Scale (DERPS), while gameful experience was measured using the Gameful Experience Scale (GAMEX). Quantitative analyses included descriptive statistics, reliability and factor analyses, Spearman correlations, and multiple linear regression models.

Results:

Participants reported significantly positive perceptions of the escape room, with DERPS scores exceeding the neutral midpoint (mean 4.0 ± 0.5; p < .001). GAMEX demonstrated high internal consistency (Cronbach’s α = .89) and confirmed its six-factor structure. Enjoyment, Creative Thinking, Absence of Negative Affect, Absorption, Activation, and Mastery were all rated significantly above or below the neutral midpoint in expected directions. Correlation analyses showed that higher levels of gameful experience were associated with more favorable perceptions and educational efficacy. In regression analyses, Enjoyment emerged as the strongest predictor of overall perception and educational efficacy, while Creative Thinking and Mastery contributed additional explanatory value.

Conclusions:

Student-designed medical escape rooms can generate highly positive gameful experiences and are perceived as educationally valuable by preclinical medical students. Enjoyment and mastery-related experiences appear to be central mechanisms underlying favorable educational perceptions. These findings support the integration of well-designed escape rooms into medical curricula and highlight the importance of affective and competence-oriented design elements in gamified learning environments.