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Bringing Gamification to Pharmacy Education: Stefanie Lehmier

“I play games as a way to escape boredom, engage socially, and for the self-fulfillment of mastering a task or situation. When I developed my core values as an educator, the same rang true,” says Stefanie George Lehmier, Pharm.D.

This assistant professor of pharmacy practice in the College of Pharmacy does more than play games in her free time. She has brought the concept of gamification to pharmacy curriculum, as shown in a recently published research study showing the benefits of using an escape room to teach diabetes management skills.

Dr. Lehmier comments here on gamification and her plans for NEOMED pharmacy curriculum.

The study “Transferability of a diabetes escape room into an accelerated pharmacy program” was completed at my previous institution, Medical College of Wisconsin School of Pharmacy, with my colleagues, Rachel Kavanaugh, Pharm.D., BCACP; and Nathan Lamberton, Pharm.D., BCPS; who helped to deliver the educational escape room and collect data. Additional researchers on our team included the original escape room developers, Jeanne Frenzel and Heidi Eukel, along with Dan Cernusca, who analyzed the data from North Dakota State University.

It all started when Rachel, Nathan and I were networking at the annual American Association of Colleges of Pharmacy meeting and met faculty from North Dakota State University, who were sharing their results after completing a diabetes-themed escape room. We kept in touch with them to learn how to recreate a similar experience within our own curriculum. After our first meeting, they graciously offered to share all of their materials to allow us to re-create the escape room at the Medical College of Wisconsin with pharmacy students. The goal of the study was to see if the results from their developed diabetes escape room were transferable when run at a different institution.

We knew an escape room would be a great team experience for our students, but we were not sure if it would be a good learning tool to complement clinical knowledge. This is why the primary focus for the original authors was to test an escape room as a mechanism to aid in memory retention of newly learned clinical content. Our results from the study did show statistically significant improvements in quiz scores after the escape room experience. When measured with  longitudinal follow-up eight weeks later, the scores maintained that improvement.

Q: Why were you interested in the idea of gamification? What do you see as its value, or how it complements classroom learning?

The literature has shown countless benefits of using game-based learning across a variety of ages and disciplines, and with a variety of games (board games, video games, cards, puzzles, role-playing, etc.). These learning benefits include improving skills such as problem solving, strategic thinking, critical thinking, technical skills, memory capacity, increased engagement and social activity. Many of these benefits are the sole reason why folks play games in the first place.

When I teach, I strive to provide engaging material and experiences, encourage teambuilding, and ultimately facilitate turning knowledge into skills. There is a natural alignment between my goals as an educator and the benefits of gamification in the classroom, which is why gamification is an important part of my teaching pedagogy.

Q: You and your colleagues talked in a video about how useful this skill was for team building. Can you explain?

Early in the process, based on our review of research on the topic and anecdotal experiences, my team and I concluded that escape rooms were a great tool for team building and for self-reflection on personal roles within a team. Similar findings have been reported in multiple settings with corporate teambuilding and even with health care teams.

Escape rooms can induce a large amount of stress from the pressure of completing many novel challenges within a limited amount of time. Whether team members know each other or not can make this an even more stressful situation. Our research team experienced this firsthand as we completed a recreational escape room prior to the study. Anecdotally, we saw the same elements of stress in the learners completing the educational escape room. We saw physical and verbal signs of stress in students, conflict between students, resolved conflict, role reversal, etc. After the escape room, I overhead one student saying to a group member something along the lines of, “I am sorry for what I said and how I acted in the escape room. I was feeling stressed and competitive and I should have listened to what you were telling me.”

Another student said, “I am sorry for all of the cursing I did during the escape room.” We also interviewed both high-performing groups (those who completed the escape room in the quickest time) and low-performing groups (those who took the longest to complete tasks) to observe common themes for exploratory data. We heard anecdotal reports of leadership, team skills used, communication strategies, stress management skills, and conflict management skills being used or not used. These types of findings have been previously reported in the literature; however, it was remarkable to witness them firsthand.

Q: You’re a clinical faculty member at NEOMED. What do you teach? Are you involved with the Wasson Center for Clinical Skills Training, Assessment, and Scholarship? Do you think an escape room could be a learning module there? What do you see as next steps for applying what you learned to student education?

I joined the NEOMED team November 2019. Currently, I am involved with didactic teaching in the evidence-based practice elective and the endocrine and gastrointestinal pharmacotherapy courses with the College of Pharmacy. I am also involved with the Pharmacy Skills Assessment task force, which creates clinical simulations using standardized patients to assess pharmacy learner skills, and I recently joined the interprofessional education team, which strives to help students learn with, from, and about each other’s roles and responsibilities in a variety of professions.

Gamification is a cornerstone of my teaching pedagogy and will continue to make an appearance in my educational offerings. Some examples of games I have used/modified in the past include Jeopardy, Family Feud, Guess Who, Match, Kahoot, Escape Rooms and Friday Night at the ER, which is an amazing team-learning simulation game used to teach quality improvement and systems thinking. I also collaborated with a team to help develop an educational murder mystery party.

Prior to the diabetes-themed escape room, I used gamification in the classroom because it made teaching fun for me and my students enjoyed it, while also learning. The educational escape room was the first time I had evaluated the outcomes of my own experiences with educational gamification. The results further motivate me to continue to use gamification as an educational strategy and to share my experiences with others.

Of course, I will continue to love and play games recreationally. While I am playing games, I am always dreaming about how I can modify said game into a learning tool.