Escape from the control room: Improving therapeutic radiography students' skills through gamification

Gamification has been developed as an innovative educational tool in healthcare that encourages student engagement, motor and transferable skills development. Educational Escape Rooms (EER) are immersive, team-based learning experiences. This pilot cross-sectional observational study presents "Escape from the Control Room", an EER designed for Therapeutic Radiography (TR) students to promote reasoning, communication, teamwork and risk management simulating a radiotherapy pathway puzzle.

The TR students had to recognise and correct clinical errors within a 45-min time frame using clues hidden in a simulated radiotherapy control room scenario. Before beginning, they completed an anonymous demographic questionnaire to assess baseline characteristics. At the end of the activity, participants completed an anonymous electronic questionnaire divided into two sections: understanding of the puzzle (multiple-choice questions) and satisfaction with the escape room experience (5-point Likert scale). A facilitator-led debriefing session ended the activities to encourage reflective learning, feedback and group discussion on specific topics.

A total of 26 TR students took part in the EER. The participants overall satisfaction was high (4.80 ± 0.40) with elevated engagement and immersion (4.88 ± 0.32). The EER was rated as educationally relevant (4.92 ± 0.27) and promoted clinical reasoning (4.65 ± 0.48), collaboration (4.76 ± 0.43), and communication (4.42 ± 0.70). The activity also led to moderate stress levels (3.73 ± 1.45), reflecting the complexity of clinical decision-making under time pressure. Improved awareness of risk management and understanding of radiotherapy error sequences was revealed during debriefing.

"Escape from the Control Room" showed a perceived enhancement of TR students' transferable skills, motivation to learn and was a useful educational activity to promote active learning through realistic clinical simulations, engagement, teamwork and a deeper understanding of radiotherapy safety protocols.

Integrating EERs into educational programmes can improve the development of transferable and motor skills. These game-based methods have the potential to enhance traditional teaching methods and prepare students for a high-pressure, multi-professional environment.