Teaching Attitude, Ethics and Communication Through the Use of An Online Escape Room for First-Year Medical Students

Modern medical education requires innovative, learner-centered strategies to cultivate essential professional attributes like empathy, communication, and ethical reasoning. While the Attitude, Ethics, and Communication (AETCOM) curriculum is mandated in India, traditional lecture-based methods often struggle to engage students in the practical application of these affective-domain competencies. This study evaluated the impact of a gamified, online escape room on the engagement and learning of first-year medical students regarding AETCOM Modules 1.2 and 1.3.

A prospective interventional study was conducted with 180 students consenting first-year MBBS. Participants collaborated in small groups to navigate a 30-minute digital escape room featuring four sequential levels of increasing complexity, focused on patient perspectives, doctor-patient relationships, and ethical dilemmas. Effectiveness was measured using Kirkpatrick's Level 1 (Reaction) via a 23-item Likert-scale and Level 2 (Learning) through pre- and post-intervention assessments. Qualitative data were analyzed using thematic analysis.

Quantitative analysis revealed a statistically significant improvement in assessment scores (p < 0.001), with mean scores rising from 13.89 + 3.14 to 14.48 + 3.14. Students reported high levels of satisfaction (mean = 4.24) and perceived the activity as highly relevant to clinical practice (mean = 4.27). Thematic analysis identified three core strengths: enhanced teamwork and collaboration, high levels of interactivity and engagement, and the stimulation of critical thinking and problem-solving skills.

Online escape rooms serve as a scalable and effective pedagogical tool for teaching foundational professional competencies. By bridging cognitive and affective learning domains, this gamified approach fosters emotional investment and collaborative learning, better preparing early-phase medical students for the complexities of patient-centered care.