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Creation and evaluation of an educational escape room in paediatric dentistry

BMC Medical Education volume 25, Article number: 504 (2025) Cite this article

Abstract

Background

Several studies have suggested the benefits of pedagogical escape games for dental students but most have involved a limited number of participants and none was conducted in paediatric dentistry. This study aims to explore dental students’ perceptions of the role of an escape room as an innovative pedagogical tool for enhancing motivation and consolidating learning in paediatric dentistry.

Methods

This study was conducted in April 2023 with all fifth-year dental students (n = 183), who were divided into 5–6 student groups to simulate the conditions of an escape room. Prior to entering the room, each student completed a 16-question true/false knowledge test to assess their general knowledge. Upon exiting the escape room, participants completed a 14-question appreciation survey. A descriptive analysis of the responses was performed, with results presented as percentages or means (and standard deviations) when appropriate, using R (version 3.6.1; R Foundation for Statistical Computing, Vienna, Austria).

Results

The 177 students reported being motivated to review their coursework in preparation for the escape game (4.3 [± 1]) and truly enjoyed the experience (4.8 [± 0.4]). Immersive learning was found to be helpful (4.3 [± 0.8]), and the escape game was rated as effective in consolidating paediatric dentistry knowledge (4.6 [± 0.6]).

Conclusions

This study highlights the potential of educational escape games as an innovative and effective pedagogical tool in paediatric dentistry, serving as a valuable supplementary strategy to diversify instruction and enhance active learning in dental education.

Peer Review reports

Background

Motivation is one of the strongest predictors of academic success [1]. The more interested students are in activities, the more they persevere and engage [2]. Lecturing is the most common method of teaching in postsecondary education [3], but relying on a single strategy can produce a saturation effect among learners [4]. Diversifying pedagogical strategies enhances success in higher education [5]. Besides, students in lecture-based classes are 1.5 times more likely to fail than students in active learning environments are [6]. Active teaching focuses on learner-centred approaches that promote participation. Gamification, which incorporates game elements into nongame contexts, is popular among undergraduate and postgraduate students and serves as an excellent training and evaluation tool [7,8,9,10]. Games allow for errors and retries [11, 12] and help students test themselves and obtain individual feedback [13]. Additionally, team-based learning fosters critical thinking skills [14]. Most studies on active learning in higher education were conducted in the context of medical school [15].

An escape game involves solving puzzles to escape a critical situation or an enclosed space, whether real or virtual, within a limited time. A game master monitors progress and provides hints when needed, allowing for a multidisciplinary approach through various puzzles. Dentistry, as a medical and surgical specialty, requires considerable equipment manipulation, manual training and diagnostic procedures. It lends itself well to the use of escape games as a learning tool. Although the current educational games for dental students are often limited to quizzes or board games [16,17,18], the benefits of pedagogical escape games for dental students have been suggested by several studies [19,20,21,22]. However, most of those studies included a limited number of participants [23, 24], except one recent large-sample study which was not in paediatric dentistry [20].

The null hypothesis is that the integration of an escape game into the paediatric dentistry curriculum dental students will not be perceived by dental students as a relevant tool to enhance their learning motivation or consolidation.

The aim of this study was to explore dental students’ perceptions of the value of an escape game as an innovative pedagogical tool for consolidating learning and enhancing motivation in paediatric dentistry.

Methods

Population

The population for this study consisted of fifth-year dental students enrolled in the Faculty of Dental Surgery at Paris City University during the 2023–2024 academic year (n = 183). A convenience sampling approach was employed. The entire cohort of fifth-year dental students (n = 183) was initially considered for participation, and the final sample included those who voluntarily agreed to participate in the study. Students were informed about the study’s objectives and procedures. All students included in the study had similar levels of theoretical knowledge, as paediatric dentistry is consistently taught in the fourth and fifth years of the curriculum (with an optional in-depth study available in the sixth year). This homogeneity minimizes variability related to prior knowledge among participants.

Ethics approval and consent to participate

This study adheres to the principles outlined in the Declaration of Helsinki. As no information related to the health of the respondents was collected, this study did not require ethical approval according to French legislation (Articles L1121-1 to L1121-3 of the French Public Health Code). However, the respondents were informed of ethical considerations, including voluntary participation, anonymity, and data usage. These considerations were approved by the CNIL (National Commission on Informatics and Liberty) (No. 2236471).

The population for this study consisted of fifth-year dental students enrolled in the Faculty of Dental Surgery at Paris City University during the 2023–2024 academic year (n = 183). Participation in the escape game was mandatory, as it was a formal component of their university curriculum. However, participation in the accompanying study - designed to evaluate the game - was entirely voluntary. Students were invited to complete two questionnaires: one before and one after the activity. Only those who provided informed consent were included in the study. Students were explicitly informed beforehand that students were assured that their participation in the study was independent of their academic performance or assessments.

In the preparation room, the student volunteers completed the consent form to take part in the study. Informed consent was obtained from all participants before the study commenced. Participants were informed of their right to withdraw from the study at any time without penalty. The questionnaires were pseudoanonymous ensuring that participants could retract their responses if necessary: the data analyst cannot identify individuals, but students can be traced if necessary, using their initials and class number. They were assured that their identity would remain confidential and that the results would be anonymous.

Conception and test phase

Calendar

The creation and implementation of the game lasted seven months, from the beginning of September 2023 to the end of March 2024. The material orders were placed in mid-February, and the β tests were carried out in mid-March. All the teachers of the discipline took part in the first test, and five sixth-year volunteer students took part in the second test. All fifth-year students took part in the escape game between April 2 and 5, 2024.

Team

The team consisted of three sixth-year students, two post-graduates, one teaching assistant and two permanent teachers. Two team members had already participated in the design of a pedagogic escape game. The inclusion of final-year students and recent graduates in the team encouraged exchange [25, 26]. The escape game was created and set up in 50 h.

Pedagogical objectives

The pedagogical objectives were defined by senior teachers. The tests focused on basic and fundamental concepts.

Theme

The chosen theme was the funfair. The puzzles were designed to withstand handling, be easily set up, be storable between teams and dismountable, have clear instructions, be accessible by six participants at the same time, and be amenable to modification over time (as the aim is for the puzzle to last several years).

Escape room

Fig. 1
figure 1

Transformation of the room before and after setting up the escape game. Figure 1a shows the room as it is for teaching purposes, and Fig. 1b shows it transformed for the escape game

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Game progress

The sessions took place over four days and included all 183 fifth-year students. Each session accommodated 22 to 28 students per half-day, who were divided into groups of four to six students. Thus, there were five sessions per half-day.

Each session proceeded as follows:

  • reception in a first room adjacent to the escape room (10 min).

  • participation in the immersive escape room game(40 min).

  • debriefing in a second adjacent room (to prevent overlap between students from different sessions).

The next session’s students were welcomed into the first room as the current session was concluding. The debriefing for the current session took place in the second adjacent room as the new session began.

Game objectives and steps

The objective was to complete the escape game as quickly as possible with minimal errors.

In the preparation room, students received additional information about the study and had the opportunity to complete and sign the consent form. Then, they answered a preescape game questionnaire containing 16 true/false questions (Table 1). Finally, a brief video described the scenario and main instructions, which were as follows: “the students were tasked with supervising their teachers’ children, who had gone missing, and were given 40 minutes to find them”.

In the escape room, all stages were numbered and needed to be resolved in order. Three supervisors were present: One acting like a game master, guiding the team and providing clues as necessary; the other 2 alternatively, received new groups in the first room, cleaned up the main room and debriefed the groups after the escape game. Throughout the week, the same teacher acted as a game master and completed a standardized evaluation grid for each team (Fig. 2). During the debriefing, teachers and students reviewed the key points of each stage and then discussed any errors reported in the evaluation grid before answering questions.

Fig. 2
figure 2

Standardized evaluation grid

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In the main hall, the session went as follows:

Stage 1– Cognitive-behavioural care and anaesthesia (Fig. 3): Choose positive terms, select anaesthesia technique sequences, identify injection points, and practice slowly administering the anesthesia.

Fig. 3
figure 3

This figure shows stage 1 of the escape game, which deals with anesthesia

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Stage 2– Global questions (Fig. 4): Answer questions using stuffed animals, catching ducks in a pool, and gathering letters to unlock a cryptex.

Fig. 4
figure 4

This figure shows stage 2 of the escape game, which includes a number of general questions on patient management in pediatric dentistry. Figure 4a shows fluffy toys with different response options, while Fig. 4b is a duck fishery with different response options

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Stage 3–Traumatology (Fig. 5): Using tarot-style cards, answer questions about the short-, medium-, and long-term care of a child.

Fig. 5
figure 5

This figure shows stage 3 of the escape game, which deals with dental traumatology

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Stage 4– Prescriptions (Fig. 6): Analyse a backpack’s contents, including an X-ray and health records, to determine the correct medication, correct dosages, and correct galenic forms and to verify the tooth needing extraction.

Fig. 6
figure 6

This figure shows stage 4 of the escape game, which deals with drugs prescription. Figure 6a shows the stage upon the arrival of the teams, while Fig. 6b shows it after the teams have played

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Stage 5– Sugars and food (Fig. 7): Identify the least cariogenic foods in colour-coded boxes.

Fig. 7
figure 7

This figure shows stage 5 of the escape game, which deals with nutrition

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Data collection tools and outcome measures

The first outcome was student satisfaction and learning experience which were evaluated with a researcher-developed questionnaire specifically designed for this study consisting of 14 items adapted from the literature (Table 1) [20]. The questionnaire was divided into four aspects: motivation (questions 1, 7 and 8), learning experience (questions 2, 3, 4, 5 and 6), quality of experience (questions 9, 10, 11, 12 and 13) and global satisfaction (question 14). Each question included five response options: strongly disagree, disagree, neutral, agree, and strongly agree (questions and results are shown in Table 1). This post-escape game questionnaire was completed after the session.

The second outcome was to assess students’ knowledge of key aspects of paediatric dentistry. This was evaluated:

  • with a researcher-developed questionnaire consisting of 16 true/false questions, also developed for this study and adapted from the literature (questions and results are shown in Table 2) [20]. This pre-escape game questionnaire was completed in the preparation room.

  • with a score reflecting time required to complete the escape game and number of errors made. The objective was to complete the escape game as quickly as possible and with minimal errors. Success is defined as a total time of less than 35 min, calculated by adding the completion time to one minute for each correction needed. To ensure that all students benefited from the same learning experience, they were not allowed to progress after making a mistake. The game master indicated the location of the error without providing the answer, except after three repeated mistakes, at which point the correct answer and explanations were given. The team with the best time won a prize.

To ensure the reliability of the two researcher-developed questionnaires, a panel of six experts in dentistry and/or statistics independently assessed each item for relevance and clarity. This expert review process ensures that the questions would be consistently interpreted and understood by participants. Additionally, the pre- and post-escape game questionnaires were administered under consistent conditions across all sessions, which further supports the reliability of the data collected. The validity of the questionnaires was addressed in two key ways:

  • content validity: items in both questionnaires were carefully adapted from the literature and reviewed by the panel of experts to ensure their relevant to the study’s objectives, including measuring student motivation, learning experience, and knowledge of key aspects of paediatric dentistry.

  • construct validity: the pre-escape game questionnaire assessed the students’ baseline knowledge, while the post-escape game questionnaire evaluated their satisfaction and learning experience, confirming that both questionnaires were valid tools for measuring the intended constructs.

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Statistical analysis

A descriptive analysis of the responses to the test and the appreciation survey was performed. The results were expressed as percentages or means (and standard deviations) when appropriate. The statistics of the results were based on all the students who completed the escape game and consented to participate in the study. Data analysis was conducted using R (version 3.6.1; R Foundation for Statistical Computing, Vienna, Austria).

Results

Student satisfaction

Three students did not complete the satisfaction survey, leaving 177 respondents. The validity rate was 96,7%. Overall, the satisfaction score was 4.8 [± 0.4], The students found the session well designed, with an appropriate level of difficulty (4.5 [± 0.6]) and duration (4.7 [± 0.6]). The group size was considered suitable at 4.2 [± 0.9]. Immersion in the escape room theme was well rated, with a score of 4.7 [± 0.5]. The students were motivated to review the course material (4.3 [± 1]), with competition increasing motivation (4 [± 1.1]). They appreciated the combination of teaching methods (4.8 [± 0.5]) and expressed a desire to participate in another escape room (4.7 [± 0.5]). The game was effective in consolidating paediatric dentistry knowledge (4.6 [± 0.6]) and had a positive clinical impact (4.3 [± 0.8]). Immersive learning was also helpful (4.3 [± 0.8]). Thus, the null hypothesis was rejected. The results are shown in Table 1.

Table 1 Escape game perception scale results (N = 177)
Full size table

Assessment of the initial knowledge level

Three students did not attend the practical session, but all the present students agreed to participate, resulting in 180 students being included in the study. The validity rate was 98,4%. The lower the total score was, the better the performance was, with an average completion time of 38.5 min (± 9.4). The best group finished in 23.6 min, while the worst group took 62.3 min. Half of the groups finished the game in 31.6 to 43.8 min, with 35% (n = 15 groups out of 38) succeeding overall (less than 35 min). The debriefing lasted from 20 to 50 min, depending on the group.

The average percentage of correct answers on the test was 82.5%. Only 1.7% (n = 3) of the students answered all the questions correctly, while 72.2% (n = 130) scored 80% or higher. The least correctly answered question was related to the diagnostic criteria of HSPM (54.4%), whereas the most correctly answered question was about the emergency management of avulsed teeth, with 99.4% correct answers. The results are shown in Table 2.

Table 2 True/False test results (n = 180)
Full size table

Discussion

To our knowledge, this is the first escape game designed specifically for paediatric dentistry. Students positively assessed the game’s design and implementation, with the majority expressing enthusiasm for participating in future escape games, in consistence with previous studies [22, 27,28,29,30].

In recent years, escape games have gained popularity in medical and dental curricula to foster teamwork [31]. Despite proven benefits in terms of learner satisfaction [22, 27], serious games remain underutilized [7, 9, 21, 32,33,34], as highlighted in a recent systematic review [22]. Previous studies [20, 23, 24, 35] have shown the effectiveness of these games for dental students. Most samples were small (n = 18, n = 24, n = 56), except for one (n = 212). None focused on paediatric dentistry. Other studies highlighted the negative impact of student stress during formal conventional simulations and revealed that learners who participated in escape games experienced lower levels of anxiety than did those who engaged in conventional simulations [28,29,30]. This finding reinforces the importance of alternative methods in reducing anxiety and promoting a more supportive learning atmosphere. Yet, paediatric dentistry is often regarded by students as one of the most stressful and challenging disciplines to practice [36].

This study assessed the value of escape games in this field with a substantial student cohort. The results indicated that fifth-year dental students at Paris-Cité University positively evaluated the game’s design and execution. Students’ overall satisfaction reached a score of 4.8 [± 0.4], with participants expressing a desire to engage in future escape room activities (4.7 [± 0.5]). El Tantawi et al. [37] reported that gamification significantly enhanced dental students’ academic writing scores, although their satisfaction levels were modest, possibly due to the mandatory nature of their participation in those activities. In the present study, as in Caussin et al. [20], while participation in the escape game was mandatory, students reported high satisfaction levels. Unlike Caussin et al. [20], the present escape game incorporates a cross-disciplinary assessment within the subject area, which requires a longer development process. Decision was made to penalize mistakes, a feature that was not included in their design. A recent qualitative study identified the key elements of effective games from medical students’ perspectives, which included integration with instructional objectives, game rules, and rapid feedback [38]. The themes in this escape game were selected by the head of the department and validated by the teaching team, as well as by 6th-year students involved in a preliminary test. The participants found the escape game relevant for consolidating their knowledge of paediatric dentistry, with a score of 4.6 (± 0.6). The statements were tested, validated and improved by the teaching team and the 6th year students during the B test. Immediate feedback on answers allowed students to assess their progress, and postsession debriefing facilitated further learning. Thus, the high degree of student satisfaction with this escape game may be attributed to the incorporation of key gamification elements in the game design.

The percentage of correct answers in the initial knowledge assessment was 82.9%, which is considered high. Zaug et al. [24] and Caussin et al. [20] reported similar results (80% and 72.1%, respectively). Note that since this is a true/false questionnaire with 16 questions, the median would be 50% if the answers were given randomly. In addition, the preescape game questions focused on topics that were largely failed by previous cohorts in the exams. Research indicates that escape rooms can intrinsically motivate students to learn [39, 40]. In the present study, the students were motivated to review their material (4.8 [± 0.5]), partly because of the prospect of winning a prize (score of 4 4 [± 1.1]). While only three students achieved a perfect score, 71.8% scored 80% or higher, indicating that students generally mastered the key knowledge expected by the end of their 5th year.

Each group consisted of four to six students, an optimal size for engaging with various hints and challenges [41, 42]. Eukel et al. [41] noted communication issues in teams larger than six. This group size seemed to facilitate active participation and self-expression (4.2 [± 0.9]). The students valued the collaborative discussions within their teams, which was reflected in a satisfaction score of 4.4 [± 0.7]. These findings align with those of Caussin et al. [20] (who reported a satisfaction score of 4.2 [± 0.9]). Similarly, Aubeux et al. [23] reported that 66.6% of students agreed that teamwork helped them assimilate new knowledge.

The level of difficulty and duration of the session are important parameters [1, 20, 21]. The total time included both the escape game duration and additional minutes for each correction needed from the game master. Success was defined as completing the escape game in under 35 min. The average completion time was 38.5 min (± 9.4), with the best group finishing it in 23.6 min and the worst group completing it in 62.3 min. 35% of the teams (n = 15 groups out of 38) succeeding overall. These results differed from those of Caussin et al. [20], who reported a 100% success rate. This difference may be due to the different definitions of success. They defined success as finishing the escape game, whereas in this study, it was defined as a score, considering time and errors, under 35 min [20]. Although there is no clear justification for setting a specific time limit, achieving the learning goals within a reasonable timeframe is considered an important factor in preventing learners from feeling frustrated and eventually dropping out [43]. Testing the duration required to complete the learning activities is crucial in determining the appropriate time limit for the escape game [44]. Quek et al. [45] reported the students’ negative reactions to the escape game regarding time constraints, lack of guidance, and absence of useful cues, highlighting the crucial role of the facilitator in ensuring team progression in the game, intervening only when necessary to promote more autonomous learners [44], and conducting debriefing sessions to foster learning through reflection [46]. Moreover, it seemed important for all the students to complete the escape game to ensure uniform learning experiences. Hence, in this study, they received guidance after mistakes; errors were identified without providing answers, except after three repeated mistakes, at which point explanations were given.

The students rated the difficulty level as suitable, with a score of 4.5 [± 0.6]. Regarding duration, Aubeux et al. [23] reported a mean escape time of 55 min, while Zaug et al. [24] reported a mean of approximately 60 min—closer to typical escape games but impractical with a cohort of 183 students. On the other hand, Caussin et al. [20], who had a sample size of 212 students, close to ours, reported a mean time of 17 min, which seems too brief to complete the experience. An educational escape room cannot follow all recreational conventions [47] while also achieving the learning objectives, therefore, the duration was extended to accommodate smaller groups while allowing participation from all students over four days. Overall, the students expressed satisfaction with the session duration, with a score of 4.7 [± 0.6].

The current investigation has several limitations. First, the logistics of the activity are time-consuming and require careful organization [25, 26]. This escape game was created and set up by an 8-person team in 50 h, which is almost twice the time reported by Caussin et al. [20]. Recognizing the importance of thorough testing [43, 48], two β tests were conducted: one with discipline teachers who did not participate in the creation phase and another with sixth-year students who volunteered. A 3-person team was needed to supervise each session. The presence of supervisors did not hinder the students’ immersion in the game [47]. Second, the findings may not be generalizable because they focus on one faculty member, but the large sample size (n = 180) strengthens the results and offers insight into this specific context. Like many gamification studies, the focus was on student perceptions, with limited exploration of instructors’ views. Third, the study lacks a control group, which limits the ability to make direct causal inferences about the unique educational value of the escape game, particularly regarding knowledge retention and engagement. This absence of comparison makes it difficult to assess how the escape room measures up against traditional teaching methods or other active learning strategies. The decision to provide the escape room experience to all students in the cohort was guided by ethical considerations, as it would be unfair to deprive some students of the complete educational experience, including the serious game and the debriefing in small groups. Thus, while the study does not directly compare the escape room with traditional teaching methods, it aims to evaluate its impact on engagement and satisfaction across all students. Fourth, the study primarily relied on immediate feedback metrics, such as student satisfaction and enjoyment, which, although valuable, do not necessarily correlate with long-term knowledge retention. Moreover the absence of long-term follow-up data prevents the assessment of whether the knowledge gained from the escape room is retained beyond the short term. Only one study reported knowledge retention for up to three months [49]. These limitations highlight the need for ongoing and future research, including studies that incorporate control groups and long-term follow-up, to more comprehensively assess the effectiveness of gamified learning in paediatric dentistry.

Further studies will be necessary for evaluating the escape room’s impact on knowledge retention, clinical competence, and overall pedagogical value in this field.

Lastly, it is important to emphasize that the escape room is a supplementary educational activity, not a replacement for traditional teaching methods. While the escape room is an engaging and interactive tool, it is not intended to substitute the rigorous traditional curriculum designed to provide students with essential clinical skills. The one-hour escape game is incorporated into the existing curriculum, and the focus remains on preparing students for real-world, clinical practice through a combination of traditional and innovative teaching strategies.

Conclusions

Active teaching methods are recommended to increase students’ motivation and success, and they can also help reduce anxiety. This study suggests that the escape game significantly enhanced learning and motivation in paediatric dentistry, as perceived by the students. Furthermore, competition with peers provided greater motivation to engage with the learning content.

Data availability

No datasets were generated or analysed during the current study.

References

  1. Plante I, O’Keefe PA, Théorêt M. The relation between achievement goal and expectancy-value theories in predicting achievement-related outcomes: a test of four theoretical conceptions. Motiv Emot. 2013;37:65–78.

    Article  Google Scholar 

  2. Renninger KA, Hidi SE. The power of interest for motivation and engagement. 1st ed. Routledge; 2017.

  3. Darling-Hammond L. Powerful teacher education: lessons from exemplary programs. San Francisco, CA: Jossey-Bass; 2006.

    Google Scholar 

  4. Joyce BR. Models of teaching. Boston: Allyn and Bacon; 2004.

    Google Scholar 

  5. Tremblay-Wragg É, Raby C, Ménard L, Plante I. The use of diversified teaching strategies by four university teachers: what contribution to their students’ learning motivation? Teach High Educ. 2021;26:97–114.

    Article  Google Scholar 

  6. Freeman S, Eddy SL, McDonough M, Smith MK, Okoroafor N, Jordt H, et al. Active learning increases student performance in science, engineering, and mathematics. Proc Natl Acad Sci U S A. 2014;111:8410–5.

    Article  Google Scholar 

  7. Amer RS, Denehy GE, Cobb DS, Dawson DV, Cunningham-Ford MA, Bergeron C. Development and evaluation of an interactive dental video game to teach dentin bonding. J Dent Educ. 2011;75:823–31.

    Article  Google Scholar 

  8. Caldas LM, Eukel HN, Matulewicz AT, Fernández EV, Donohoe KL. Applying educational gaming success to a nonsterile compounding escape room. Curr Pharm Teach Learn. 2019;11:1049–54.

    Article  Google Scholar 

  9. Hannig A, Lemos M, Spreckelsen C, Ohnesorge-Radtke U, Rafai N. Skills-O-Mat: computer supported interactive motion- and game-based training in mixing alginate in dental education. J Educ Comput Res. 2013;48:315–43.

    Article  Google Scholar 

  10. Wang R, DeMaria S, Goldberg A, Katz D. A systematic review of serious games in training health care professionals. Simul Healthc. 2016;11:41–51.

    Article  Google Scholar 

  11. Gorbanev I, Agudelo-Londoño S, González RA, Cortes A, Pomares A, Delgadillo V, et al. A systematic review of serious games in medical education: quality of evidence and pedagogical strategy. Med Educ Online. 2018;23:1438718.

    Article  Google Scholar 

  12. Bigdeli S, Kaufman D. Digital games in health professions education: advantages, disadvantages, and game engagement factors. Med J Islam Repub Iran. 2017;31:117.

    Article  Google Scholar 

  13. Olms C, Jakstat HA, Haak R. Elaborative feedback in clinical dental teaching—An assessment from the students’ perspective. Ann Anat. 2017;212:48–54.

    Article  Google Scholar 

  14. Ihm J, Shin Y, Seo DG. Did clinical reasoning and knowledge questions during team-based learning enhance dental students’ performance in esthetic dentistry? J Dent Educ. 2020;84:495–501.

    Article  Google Scholar 

  15. Torralba KD, Doo L. Active learning strategies to improve progression from knowledge to action. Rheum Dis Clin N Am. 2020;46:1–19.

    Article  Google Scholar 

  16. Pereira AC, Walmsley AD. Games in dental education: playing to learn or learning to play? Br Dent J. 2019;227:459–60.

    Article  Google Scholar 

  17. Anyanwu EG. Anatomy adventure: a board game for enhancing understanding of anatomy. Anat Sci Educ. 2014;7:153–60.

    Article  Google Scholar 

  18. Dhaliwal HK, Allen M, Kang J, Bates C, Hodge T. The effect of using an audience response system on learning, motivation and information retention in the orthodontic teaching of undergraduate dental students: a cross-over trial. J Orthod. 2015;42:123–35.

    Article  Google Scholar 

  19. Berthod F, Bouchoud L, Grossrieder F, Falaschi L, Senhaji S, Bonnabry P. Learning good manufacturing practices in an escape room: validation of a new pedagogical tool. J Oncol Pharm Pract. 2020;26:853–60.

    Article  Google Scholar 

  20. Caussin É, Qatramiz A, Guillemot C, Brukarz Y, Loré V, Jungo S, et al. Creation and evaluation of an educational escape room for preclinical training on 3D printing in dentistry. Eur J Dent Educ. 2024;28:707–17.

    Article  Google Scholar 

  21. Haoran G, Bazakidi E, Zary N. Serious games in health professions education: review of trends and learning efficacy. Yearb Med Inf. 2019;28:240–8.

    Article  Google Scholar 

  22. Sipiyaruk K, Gallagher JE, Hatzipanagos S, Reynolds PA. A rapid review of serious games: from healthcare education to dental education. Eur J Dent Educ. 2018;22:243–57.

    Article  Google Scholar 

  23. Aubeux D, Blanchflower N, Bray E, Clouet R, Remaud M, Badran Z, et al. Educational gaming for dental students: design and assessment of a pilot endodontic-themed escape game. Eur J Dent Educ. 2020;24:449–57.

    Article  Google Scholar 

  24. Zaug P, Gros CI, Wagner D, Pilavyan E, Meyer F, Offner D, et al. Development of an innovative educational escape game to promote teamwork in dentistry. Eur J Dent Educ. 2022;26:116–22.

    Article  Google Scholar 

  25. Cain J. Exploratory implementation of a blended format escape room in a large enrollment pharmacy management class. Curr Pharm Teach Learn. 2019;11:44–50.

    Article  Google Scholar 

  26. Dietrich N. Escape classroom: the leblanc process—an educational escape game. J Chem Educ. 2018;95:996–9.

    Article  Google Scholar 

  27. Rodrigez-Andres D, Juan MC, Molla R, Mendez-Lopez M. A 3D serious game for dental learning in higher education. In: 2017 IEEE 17th international conference on advanced learning technologies (ICALT). Timisoara, Romania: IEEE; 2017. pp. 111-5.

  28. Ignacio J, Dolmans D, Scherpbier A, Rethans J-J, Chan S, Liaw SY. Stress and anxiety management strategies in health professions’ simulation training: a review of the literature. BMJ Simul Technol Enhanc Learn. 2016;2:42–6.

    Article  Google Scholar 

  29. Molina-Torres G, Sandoval-Hernández I, Ropero-Padilla C, Rodriguez-Arrastia M, Martínez-Cal J, Gonzalez-Sanchez M. Escape room vs. traditional assessment in physiotherapy students’ anxiety, stress and gaming experience: a comparative study. Int J Environ Res Public Health. 2021;18:12778.

    Article  Google Scholar 

  30. Powers K, Brandon J, Townsend-Chambers C. Preparing nursing students for home health using an escape room: a qualitative study. Nurse Educ Today. 2022;108:105215.

    Article  Google Scholar 

  31. Zhang XC, Lee H, Rodriguez C, Rudner J, Chan TM, Papanagnou D. Trapped as a group, escape as a team: applying gamification to incorporate team-building skills through an ‘escape room’ experience. Cureus. 2018;10:e2256.

    Google Scholar 

  32. Blakely G, Skirton H, Cooper S, Allum P, Nelmes P. Educational gaming in the health sciences: systematic review. J Adv Nurs. 2009;65:259–69.

    Article  Google Scholar 

  33. Germa A, Gosset M, Gaucher C, Valencien C, Schlumberger M, Colombier ML, et al. OSCEGame: a serious game for OSCE training. Eur J Dent Educ. 2021;25:657–63.

    Article  Google Scholar 

  34. Lemos M, Wolfart S, Rittich AB. Assessment and evaluation of a serious game for teaching factual knowledge in dental education. BMC Med Educ. 2023;23:521.

    Article  Google Scholar 

  35. Khorasanchi M, Hoseinzadeh M, Khadem Rezaeian M, Kazemian A, Moradi A, Sarabadani J. The development of a serious game for laser applications in dentistry and the evaluation of dental students’ satisfaction. BMC Med Educ. 2024;24:583.

    Article  Google Scholar 

  36. Piazza-Waggoner CA, Cohen LL, Kohli K, Taylor BK. Stress management for dental students performing their first pediatric restorative procedure. J Dent Educ. 2003;67:542–8.

    Article  Google Scholar 

  37. El Tantawi M, Sadaf S, AlHumaid J. Using gamification to develop academic writing skills in dental undergraduate students. Eur J Dent Educ. 2018;22:15–22.

    Article  Google Scholar 

  38. Wang Y-F, Hsu Y-F, Fang K-T, Kuo L-T. Gamification in medical education: identifying and prioritizing key elements through Delphi method. Med Educ Online. 2024;29:2302231.

    Article  Google Scholar 

  39. Giang C, Chevalier M, Negrini L, Peleg R, Bonnet E, Piatti A, et al. Exploring escape games as a teaching tool in educational robotics. In: Moro M, Alimisis D, Iocchi L, editors. Educational robotics in the context of the maker movement. Cham: Springer International Publishing; 2020. pp. 95–106.

    Chapter  Google Scholar 

  40. Peleg R, Yayon M, Katchevich D, Moria-Shipony M, Blonder R. A lab-based chemical escape room: educational, mobile, and fun! J Chem Educ. 2019;96:955–60.

    Article  Google Scholar 

  41. Eukel HN, Frenzel JE, Cernusca D. Educational gaming for pharmacy students - design and evaluation of a diabetes-themed escape room. Am J Pharm Educ. 2017;81:6265.

    Article  Google Scholar 

  42. Watermeier D, Salzameda B. Escaping boredom in first semester general chemistry. J Chem Educ. 2019;96:961–4.

    Article  Google Scholar 

  43. Hermanns M, Deal B, Campbell AM, Hillhouse S, Opella JB, Faigle C, et al. Using an escape room toolbox approach to enhance pharmacology education. J Nurs Educ Pract. 2017;8:89.

    Google Scholar 

  44. Makri A, Vlachopoulos D, Martina RA. Digital escape rooms as innovative pedagogical tools in education: a systematic literature review. Sustainability. 2021;13:4587.

    Article  Google Scholar 

  45. Quek LH, Tan AJQ, Sim MJJ, Ignacio J, Harder N, Lamb A, et al. Educational escape rooms for healthcare students: a systematic review. Nurse Educ Today. 2024;132:106004.

    Article  Google Scholar 

  46. Sanchez E, Plumettaz-Sieber M. Teaching and learning with escape games from debriefing to institutionalization of knowledge. In: Gentile M, Allegra M, Söbke H, editors. Games and learning alliance. GALA 2018. Lecture notes in computer science. Volume 11385. Cham: Springer International Publishing; 2019. pp. 242–53.

    Google Scholar 

  47. Veldkamp A, van de Grint L, Knippels M-CPJ, van Joolingen WR. Escape education: a systematic review on escape rooms in education. Educ Res Rev. 2020;31:100364.

    Article  Google Scholar 

  48. Mills J, King E, Exploration. ESCAPE! Puzzling out learning theories through play. In: James A, Nerantzi C, editors. The power of play in higher education: creativity in tertiary learning. Cham: Springer International Publishing; 2019. pp. 33–41.

    Chapter  Google Scholar 

  49. Alejandre C, Corniero P, Claret G, Alaez C, Esteban E, Jordan I. New resident training strategy based on gamification techniques: an escape room on sepsis in children. Children. 2022;9:1503.

    Article  Google Scholar 

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Acknowledgements

Thanks to Clara Cuer, Michel Benyamin, Baptiste Cochard, Rosalie Attal and Bastien Moreau for testing the escape game.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Paediatric Dentistry, Faculty of Dental Surgery, Paris Cité University, Paris, France

    Sandrella Hamdan, Violaine Smail Faugeron & Elisabeth Dursun

  2. EA732, Paris Cité University, Paris, France

    Sandrella Hamdan & Violaine Smail Faugeron

  3. Bretonneau Hospital, Paris, France

    Sandrella Hamdan, Anne Aragou, Julie Grange, Amélie Lefort-Louet, Aylin Sari, Yasmine Smail, Violaine Smail Faugeron, Mathieu Izart & Philippe François

  4. Department of Restorative Dentistry, Faculty of Dental Surgery, Paris Cité University, Paris, France

    Mathieu Izart

  5. Inserm UMR 1333 - Oral Health, Paris Cité University, Montrouge, France

    Yasmine Smail, Jean-Pierre Attal, Philippe François & Elisabeth Dursun

  6. Department of Dental Materials, Faculty of Dental Surgery, Paris Cité University, Paris, France

    Yasmine Smail, Jean-Pierre Attal & Philippe François

  7. Charles Foix Hospital, Ivry-sur-Seine, France

    Jean-Pierre Attal

  8. Henri Mondor Hospital, Créteil, France

    Elisabeth Dursun

  9. Chimie ParisTech UMR 8247, Chemistry Research Institute of Paris CNRS, Paris, France

    Mathieu Izart

Authors
  1. Sandrella Hamdan
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  2. Anne Aragou
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  11. Elisabeth Dursun
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Contributions

ED chose the thematic focus of the project and was a major contributor in writing the manuscript. PF contributed expertise in escape games, designed Station 2 and was a major contributor in writing the manuscript. JPA provided expertise in innovant pedagogic. AA was responsible for distributing questionnaires, collecting data, designing the tarot cards, procuring materials, and developing Station 1. AS designed Station 5. JG created the tarot card illustrations and designed Station 3. AL developed Station 4. YS was responsible for configuring the box settings. SH supervised the entire project, oversaw each station, coordinated the team, performed the statistical analysis and was the main author of this manustricpt. VSF and MI reviewed the manuscript.All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Sandrella Hamdan or Elisabeth Dursun.

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Hamdan, S., Aragou, A., Grange, J. et al. Creation and evaluation of an educational escape room in paediatric dentistry. BMC Med Educ 25, 504 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12909-025-06667-0

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  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12909-025-06667-0

Keywords

BMC Medical Education

ISSN: 1472-6920

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