Engaging Undergraduate Medical Students With Introductory Research Training via an Educational Escape Room: Mixed Methods Evaluation.

Background: Early exposure to research methodology is essential in medical education, yet many students show limited motivation to engage with nonclinical content. Gamified strategies such as educational escape rooms may help improve engagement, but few studies have explored their feasibility at scale or evaluated their impact beyond student satisfaction. Objective: This study aimed to assess the feasibility, engagement, and perceived educational value of a large-scale escape room specifically designed to introduce third-year medical students to the principles of diagnostic test evaluation. Methods: We developed a low-cost immersive escape room based on a fictional diagnostic accuracy study with 6 puzzles mapped to five predefined learning objectives: (1) identifying key components of a diagnostic study protocol, (2) selecting an appropriate gold standard test, (3) defining a relevant study population, (4) building and interpreting a contingency table, and (5) critically appraising diagnostic metrics in context. The intervention was deployed to an entire class of third-year medical students across 12 sessions between March 2023 and April 2023. Each session included 60 minutes of gameplay and a 45-minute debriefing. Students completed pre- and postintervention questionnaires assessing their knowledge of diagnostic test evaluation and perceptions of research training. Descriptive statistics and 2-tailed paired t tests were used to evaluate score changes; univariate linear regressions assessed associations with demographics. Free-text comments were analyzed using the hierarchical classification by Reinert. Results: Of the 530 participants, 490 (92.5%) completed the full evaluation. Many participants had had limited previous exposure to escape rooms (206/490, 42% had never participated in one), and most (253/490, 51.6%) reported low initial confidence with critical appraisal of scientific articles. Mean overall knowledge scores increased from 62 of 100 (SD 1) before to 82 of 100 (SD 2) after the activity (+32%; P<.001). Gains were observed across all learning objectives and were not influenced by age, sex, or previous experience. Students rated the educational escape room as highly entertaining (mean score 9.1/10, SD 1.1) and educational (mean score 8.2/10, SD 1.5). Following the intervention, 86.9% (393/452) felt more comfortable with critical appraisal of diagnostic test studies, and 79% (357/452) considered the escape room format highly appropriate for an introductory session. Conclusions: This study demonstrates the feasibility and enthusiastic reception of a large-scale, reusable escape room aimed at teaching the fundamental principles of diagnostic test evaluation to undergraduate medical students. This approach may serve as a valuable entry point to engage students with evidence-based reasoning and pave the way for deeper exploration of medical research methodology.