Exploring the Effects of Virtual and Physical Escape Rooms in Pharmacy Ethics and Legislation

To develop and evaluate both physical and virtual educational escape rooms (VER) for teaching ethics and legislation in pharmacy and to assess their impact on knowledge and perceptions among third-year student pharmacists.

A quasi-experimental intervention study was conducted in which the physical and VER were designed around 4 stations based on various acts and regulations in pharmacy. They were implemented during tutorial sessions across 2 cohorts of third-year student pharmacists, 2023/2024 and 2024/2025. Pre- and postknowledge assessments on ethics and legislation were used to measure the effectiveness of the intervention. A 12-item questionnaire captured participants' perceptions, along with demographic data and prior escape room experience. Descriptive statistics summarized demographic data, while nonparametric statistics analyzed knowledge assessments and sociodemographic associations with participants' perceptions.

One hundred and thirty-one students participated, with 38.9% attending a physical escape room. Both formats significantly improved participants' knowledge, with the virtual format showing greater gains and retention, reflected in 4% higher final examination performance, with average scores of 79.34 ± 5.94%. Participants reported that either format was effective for reviewing content, learning new information, and supporting understanding of legislation topics. No notable differences in perceptions were observed between the 2 formats. Gender-related differences in learning concentration under stress were noted, but prior experience with escape rooms did not affect perceptions.

Educational escape rooms, whether physical or virtual, are effective tools for enhancing student pharmacists' knowledge of ethics and legislation and fostering positive learning perceptions. The virtual format may offer added benefits for knowledge retention.