Escaping the ordinary: Mechanics, dynamics, and aesthetic-guided design and evaluation of an escape room for high yield review in basic medical sciences.

Escape rooms (ERs) offer an immersive, time-constrained, puzzle-solving environment that mirrors real-world challenges and fosters collaboration. This study aimed to evaluate the design and implementation of an ER for medical students preparing for a high-stake examination using the Mechanics-Dynamics-Aesthetics (MDA) framework. Designed for flexibility, the game can be delivered in-person, online, or in a hybrid format, and utilizes a low-cost board/card style game structure to ensure accessibility and feasibility. Key design considerations included fostering peer collaboration, building excitement and tension, visual and narrative immersion, and ease of implementation. To evaluate the game, we collected both quantitative and qualitative data through post-game surveys and direct observation of gameplay. Deductive coding of qualitative feedback was used, and final codes were mapped to the MDA framework. Players reported high levels of overall satisfaction with the game experience. Analysis revealed that elements of the aesthetics and game mechanics contributed to emotional immersion, which facilitated learning and mirrored test-taking pressures. Dynamics such as collaborative puzzle-solving and strategy were observed. This study demonstrates that ERs can be a valuable pedagogical strategy for high-stake examination review as they mimic a high-pressure scenario for cognitive rehearsal. Using the MDA framework for both game design and evaluation provided valuable insights into how specific elements influence learner experience. The emotional and collaborative nature of the game makes it a promising model for educators seeking to enhance review sessions through gamified learning.