Can you escape rehab? Theoretical and design foundations of an online escape room for speech-language pathology students.

Background: Speech-language pathology (SLP) students in South Africa often face persistent challenges in transferring theoretical learning to authentic clinical contexts. This theory-practice divide is compounded by limited placement opportunities, multilingual classrooms, and broader structural inequities, all of which contribute to a significant theory-practice divide. Addressing these contextual realities requires innovative pedagogical approaches that extend beyond traditional teaching methods. Objectives: This article presents the conceptual and theoretical foundations of a low-cost, online escape room aimed at enhancing clinical reasoning skills in third-year SLP students, grounded in the contextual realities of South African higher education. Method: The design was informed by social constructivism, self-determination theory, and simulation-based learning. Implemented via the Genial.ly platform, the escape room integrated authentic case-based tasks, facilitator-mediated feedback, progress-dependent sequencing, and multimedia layering. These features created an interactive, psychologically safe space where students could apply theoretical knowledge to contextually relevant clinical challenges. Results: The design foregrounds social learning, motivation, and contextual responsiveness - core dimensions of capability building in resource-limited systems. It demonstrates how theoretically informed, technology-enhanced learning can promote autonomy, competence, and relatedness, supporting the development of confident and reflective practitioners in multilingual and under-resourced environments. Conclusion: This article proposes a scalable and contextually responsive model for developing clinical reasoning in the Global South healthcare education contexts. By foregrounding theoretical grounding and contextual adaptability, it contributes to the broader conversation on how technology-enhanced learning can support capability development in resource-limited settings. Clinical implications: The online escape room illustrates the potential of low-fidelity, technology-enhanced simulations to improve clinical reasoning, learner engagement, and confidence in diverse, resource-constrained training contexts, providing an equitable, scalable means to bridge theory and practice.