The summer months feature opportunities to participate in numerous traditional non-videogaming activities, such as baseball, softball, tennis, swimming, hiking, fishing, and bike riding.
But a developing craze over the past few years, one that tests mental capacities and gets competitive juices flowing, has been escape rooms. Escape rooms are just fun — there’s simply no escaping that.
Knowing that and wanting to provide students with a unique learning opportunity, a group of faculty members at Virginia Tech Carilion School of Medicine (VTCSOM) partnered with REACH, a nonprofit organization in Roanoke dedicated to transforming the community, to offer students an escape room experience at First Christian Church over a two-Thursday span in late April. 
The group of faculty members received a grant from the university’s Center for Excellence in Teaching and Learning to pay for the experience.
“We have been trying to promote more active learning and move away from traditional didactic lectures to promote a deeper level of learning and retention,” said Jennifer Cleveland, an assistant professor of basic science education at VTCSOM.  “Active learning is more challenging for the learners because they need to retrieve and apply information in different scenarios.”
The group of faculty members investigated different mechanisms for active learning. They already do things such as jigsaw puzzles, concept mapping, and generating illness-scripts with students. Pamela Adams, a medical education manager, suggested an escape room, and after some research, the group liked the possibilities.
“The idea of gaming in education is not new,” said Renée LeClair, an associate professor of basic science education at VTCSOM. “The use of escape rooms for educational delivery have been shown to motivate learners, increase engagement, and promote social interaction. It also allows for integration of lots of different educational content.
“In this model, you can move learning foundational material into a task that requires teamwork and collaboration — elements of lifelong learning and a hallmark of medical education.”
The group decided to team with REACH, which stands for Real Experiences Affecting CHange. Founded in 2011 by Tim Dayton, REACH engages individuals in experiences designed to share the “joy of service,” the unique satisfaction and happiness that comes from helping others. The organization involves volunteers in rehabbing houses in the southeast Roanoke area and holds camps for young people who then volunteer for an array of service-related projects. Their goal is to get more people engaged in some form of service in Roanoke and beyond.


Brad Stephens handing out a clue during VTCSOM's game room outing
Brad Stephens (at left), the executive director of REACH, hands a clue to a participant during the game. "It’s a mix of having fun and education," Stephens said of REACH's purpose for offering a game room experience. Photo by Ryan Anderson for VIrginia Tech.

The organization also looks to build empathy and facilitate more effective service through its Escape from Poverty Room, which recently reopened after being shut down because of the COVID-19 pandemic. The purpose of the escape room is two-fold, according to Brad Stephens, the executive director of REACH.
“It’s a mix of having fun and education,” Stephens said. “We want to educate people about the psychological stress of being in poverty. But it’s hard to even have a conversation about poverty these days. It feels too big to engage with. So by making it fun, we can hopefully reach more people and facilitate these vital conversations. Otherwise, nobody is going to show up. So this is really a way to get people engaged in a conversation that they wouldn’t normally have about poverty, but also have a great time and foster connections.”
REACH’s escape room involved a series of clues. All students, along with staff and faculty members who also were invited to participate, were required to figure out the answer for each clue before continuing to the next clue, with the final clue leading to escaping the room. However, this escape room came with a twist in that each group needed to have a certain amount of money available to win the game.
The game featured a combination of getting paid and paying bills over a 50-minute span. Every five minutes, Stephens either collected payment for bills or paid the group its salary (using fake money, of course), and he also had them draw a card. The cards could mean paying additional expenses or conversely be a way to supplement the group’s income, both of which can happen in real-life situations.
“I think there was a moment in there when I was counting the money, and it felt real,” first year VTCSOM student Alex In said. “I remember that stress of, ‘Oh my gosh, how am I going to pay for this.’ … They did a good job of adding that pressure and having us feel a little what people are going through in terms of finances, and I’m sure it’s 10 times more stressful than it was playing a game. But it did put into perspective that there are people around us who are going through that.”
Though just a game, an escape room forces competitors to use logic, deduce clues, follow instincts, and be collaborative. They need to be observant of the surroundings and be able to think outside the box. And maybe most importantly, each competitor needs to be adept at convincing others when to follow if this person feels strongly about an answer or position.


Students unlocking a trunk at VTC's escape room outing
At one point in the 50-minute game, participants had to find the key that unlocked this trunk to find the next clue. Photo by Ryan Anderson for Virginia Tech.

These are also the exact traits that medical school students need to exhibit once they become doctors working in hospitals and clinics. And being exposed to living from paycheck to paycheck adds to their experience — an important point considering that 70 percent of the uninsured population in the U.S. lives in poverty, according to the University of Wisconsin’s Institute for Research on Poverty.
“We are trained to ask questions regarding diet and housing and transportation, exercise, hobbies, who you live with — all of those kinds of social factors that could play a role in health care and to their current health status,” first-year VTCSOM student Monica Gerber said. “My eyes are just opened [after participating in the escape room]. Walking down the street, I’ll be able to take a step back and just think about the perspectives of the people I see around me and have a lot more empathy and understanding for what they might be going through.”
In the weeks after the escape room experiences, the group of faculty members surveyed the participants to secure feedback. The members wanted to know if the participants enjoyed the experience, but they also had more important reasons for getting the participants’ insights.
“We’re really hoping to get some learner support for this to actually incorporate this formally as a curricular element,” LeClair said. “That had been our goal all along, but now we have the opportunity to ask the learners, ‘Do you value this to a level where we could make this activity part of the course your coursework?’ I think it’s important to get some stakeholder feedback on that.
“Of course, we want feedback on the topic as well. Should we be adding other social or societal elements and what was their overall feeling toward the activity? Should it be longer? Should it have more complex tasks? Was the group size too big or too small? So, we’re looking at both the emotional aspects and the structural aspects of the activity.”
VTCSOM students already involve themselves in the greater Roanoke community. They volunteer at the Bradley Free Clinic, the VTC Public Health Club, MedDOCs, and they played a huge role in vaccinations and testing during the COVID-19 pandemic. These activities are valued by students and community partners alike. 
The escape room experience forced them to account for social factors when practicing medicine. The faculty members at VTCSOM view those types of learning opportunities as invaluable, which is why they plan to continue pushing for more of these in the future.
“I am hopeful we can utilize and expand this activity,” Cleveland said. “This could encompass utilizing this learning activity on a smaller scale with medical students to integrate basic science concepts or on a larger scale to continue partnering with REACH and integrate the Escape from Poverty room into other curricular domains with other professional learners from other programs.”



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