Presented By: Michelle Rusch, University of Illinois College of Medicine Peoria
Co-Authors: Aaron Costerisan, University of Illinois College of Medicine Peoria, Carle Health - Methodist
Toufic Khairallah, Tyrian HealthCare, LLC
Michael Neff, University of Illinois College of Medicine Peoria
Peter Phan, University of Illinois College of Medicine at Peoria
Greg Podolej, University of Illinois College of Medicine Peoria
AJ Pool, University of Illinois College of Medicine Peoria
Kevin Wombacher, University of Illinois College of Medicine Peoria

Purpose 
Research indicates performance in real-life settings depends on domain knowledge established through a combination of content and procedural knowledge. This criteria presents a challenge to training procedural skills in medicine with meaningful context. Training must be strategically delivered and assessed to effectively achieve and measure mastery. The purpose of this research was to evaluate the effectiveness of a simulation-based pseudo escape room to improve student engagement and skill mastery of third year medical students. 

Methods 
The finale for a third year medical student (n=57) clinical skills course utilized a simulation-based pseudo-escape room format. Skills tested included US, Airway, IV, EKG Placement, Foley, and ABG or NG placement. Each group (4-5 students) had 45 minutes to complete the escape room. Time, error rates, and clinical logic via ABC accuracy (prioritizing airway > breathing > circulation) were recorded to measure performance. Follow-up and long-term effectiveness was measured via questionnaires including adapted versions of the SET-M, Simulation Design Scale, and Science Motivation Scale II. 

Results 
Average unadjusted completion times for the ABG and NG groups were 28.36 minutes (SD=5.44) and 34.18 minutes (SD=5.46), respectively. ABC accuracy for ABG groups (mean=1.00, SD=0.71) was higher than NG groups (mean = 0.50, SD = 0.55). Findings on adjusted scores (factoring errors) in relationship to follow-up surveys are forthcoming. 

Conclusion 
Results showed a broad range of performance scores and revealed a need for additional US training on fundamental skills. Lessons learned from this first activity informed revisions to the curriculum. For example, adding tests and training on situation awareness and flow. The escape room format presents a promising alternative for medical educators with the potential to increase student engagement and long-term retention of skills.