P134: Escape game as a theatre-based simulation for teamwork skills training in undergraduate medical education

Abstract

Introduction: Teamwork skills are essential in emergency presentations. When training medical students to manage acute care cases, simulation is frequently the educational tool. However, simulation content is often medically-focused, and post-simulation debriefs may not prioritize discussion of teamwork skills, as time is limited. Furthermore, debriefing both medical and teamwork aspects of a case may add to the learners cognitive load. This innovation uses an escape game as a non-clinical simulation to gamify teamwork skills training, with a focus on the collaborator CanMEDS role. In the entertainment industry, escape games are activities where teams solve a series of puzzles together to ultimately escape a room. Methods: 2 groups of 5 second-year medical students piloted the escape game, created within a simulation theatre, designed to surface teamwork competencies under the four University of Calgary Team Scheme domains (adapted from CIHCs National Interprofessional Competency Framework and TeamSTEPPS): Leadership/Membership, Communication, Situation Monitoring, and Collaborative Decision-Making/Mutual Support. During the game, facilitators noted examples of students strengths and challenges in demonstrating teamwork competencies. Post-game, a debrief and written reflective exercise enabled students to analyze successes and challenges in demonstrating teamwork competencies, propose solutions to teamwork challenges, and write 3 goals to improve teamwork skills. All competencies listed under each Team Scheme domain represented themes used in a thematic analysis to uncover students reported teamwork challenges. Results: Each escape game is a 30-minute teamwork activity where 5 students collaborate to complete 8 puzzles, which do not require medical knowledge, in order to win. Briefing is scheduled for 15-minutes, whereas post-game debriefing and reflection is 45-minutes. Conclusion: Escape games can highlight strengths and challenges in teamwork and collaboration amongst second-year medical students. Every competency under the Team Scheme domains was highlighted by the escape game pilots, touching on both strengths and challenges, for which students demonstrated, debriefed, and reflected upon. Students self-documented teamwork challenges include issues surrounding task-focused, closed-loop communication, and frequent reassessments. Advantages of this innovation include its use as a learning progression towards acute care simulations, portability and affordability, potential interprofessional use, and customizability. Additional training time may be required to orient facilitators to this atypical simulation. The escape game will launch in MDCN490 for second-year medical students and is scheduled prior to their acute care simulations. Further teamwork challenges identified at that time will help inform teamwork curriculum development for year 3.