Date of Award

Fall 2025

Document Type

Open Access Dissertation

Department

Educational Studies

First Advisor

Fatih Ari

Abstract

The purpose of this mixed-methods action research is to integrate game-based learning (GBL), specifically an educational escape room, into case-based learning (CBL) and evaluate its impact on the engagement and academic performance of fourth-year medical students in an elective radiology course at a medical school in the southeastern United States. Sixteen students participated in the study; all identified as white. National trends indicate a significant decrease in student engagement and academic performance across various educational settings, including medical education (Kay & Pasarica, 2019). Locally, this trend is reflected in declining test scores and student feedback indicating disengagement and poor retention of complex radiological content. Integrating GBL into CBL has shown promise in enhancing student engagement and academic performance (Kanthan & Senger, 2011; Lavoué et al., 2021). This study sought to answer the following research questions: How does integrating game-based learning via an educational escape room into case-based learning impact fourth-year medical students' academic performance in an elective radiology course? How and to what extent does integrating game-based learning via an educational escape room into case-based learning impact fourth-year medical students' engagement in an elective radiology course? What are fourth-year medical students' perceptions about integrating game-based learning via an educational escape room into case-based learning in an elective radiology course?

A mixed-methods action research design was used, incorporating a radiology-themed educational escape room into the CBL curriculum. Quantitative data included pre- and post-intervention radiology knowledge tests and course evaluations. Qualitative data were collected from engagement questionnaires, semi-structured interviews, exit tickets, and reflection journals. Findings indicated improved post-test scores compared to pre-test scores, increased self-reported engagement, and positive perceptions of the escape room activity. Thematic analysis revealed that participants valued the interactivity,competition, and collaborative problem-solving inherent in the escape room format, which enhanced understanding and retention of content.

These results suggest that incorporating educational escape rooms into CBL can foster both cognitive and emotional engagement, potentially improving learning outcomes in radiology education. This approach may serve as a model for other medical education contexts seeking to address disengagement and content retention challenges.

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© 2025, Lisa Willson

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