Table 3 These focus group interview excerpts were selected to illustrate participants’ experiences and perceived learning outcomes of narrow learning objectives in a medical escape room. Themes are presented in the left column, with main themes in bold. The right column contains focus group interview excerpts translated from Danish to English. Brackets indicate the interviewer and participant in pseudonymised form

Experience with narrow learning objectives

 Restrictions

[INT 2, PERS 2] It was a narrow learning objective, but I feel there was freedom to say whatever you wanted.

 Wishes for other topics

[INT 5, PERS 3] (…) I think that we discussed it quite well (…) it is not like I feel that there are that many other topics which I need to discuss.

Topics discussed in debriefing

 Exchange of information

[INT 2, PERS 1] In some way, I feel that communication is wider. Exchange of information becomes very instrumental in some way, very concrete. Whereas communication is also when you lay a hand on someone’s shoulder to say, “You are doing okay”. I do not necessarily feel that it is an exchange of information.

[INT 3, PERS 4] (…) if the question posed was simply “What did you get from it regarding communication?”. If you were presented with that and nothing else, then it would maybe have been things like distribution of roles and short messages, but we would not have come up with all the other stuff with the non-verbal communication and such. (…)

 Other topics

[INT 4, PERS 1] (…) I also think that we discussed the other things a lot, but this was in the context of exchange of information.

Learning mechanisms

 A single focus

[INT 4, PERS 2] (…) focusing exclusively on the communication improves the communication part, as opposed to focusing on different topics at the same time (…)

 Effects of narrow learning objective

[INT 2, PERS 4] (…) it was nice that there was an angle on the discussion we had afterwards, as it makes the outcome greater. (…) we said many things building on something someone else had said earlier, and you would probably not have done so much if all four had had different agendas (…)

[INT 6, PERS 1] (…) despite the discussion veering in various directions, you can say ”The purpose of today was investigating communication”.

 Keeping focus with facilitation techniques

[INT 4, PERS 3] (…) if we veered off somewhere that was not relevant, we were advised to consider its relevance to communication, and then we got it back on track again. (…)

 Facilitation techniques’ effects on learning outcome

[INT 2, PERS 2] (…) I do not at all think that I would have had the same outcome if it (the debriefing ed.) had not been structured. Because verbalising things and getting help perceiving things in our communication, which we had not considered ourselves. If we were just to sit down and talk within the group, then I do not think that we would have gone over it as deeply and become aware of what we had said and in which ways.

Perceived learning outcomes in relation to exchange of information

 Knowledge

[INT 2, PERS 2] (…) reflecting on it, I actually used a lot of communication tools, and I have also become aware of ways to communicate (…)

[INT 6, PERS 2] It is also a takeaway. (…) thinking about that sometimes you have to do some tasks together. How do we make sure that the communication becomes as good as possible?

 Skills

[INT 5, PERS 3] (…) something about learning to sort the redundant away.

 Attitude change

[INT 3, PERS 4] (…) that people do not always look at it the same way you do. So, the thing about being concrete in what you say that’s what I took with me the most.

 No new learning

[INT 4, PERS 4] We had heard all the stuff before, so I do not know if you learn, but it was like a reminder of how important some of it is.

[INT 6, PERS 4] I do not feel that I learned anything new regarding medical expertise.

Influence of the learning approach

 Educational value of the video lecture

[INT 3, PERS 4] (…) it was a little, well, trivial. I found my attention wavering at that point. So, I got the most out of it when we discussed it afterwards as it got tied to something concrete.

[INT 4, PERS 1] (…) it like set the scene for ”What it actually is we are going to play within this learning session.”

[INT 6, PERS 1] (…) if we had not had the lecture, then we might not have been able to remember the stuff there is to communication.

 Learning objective in the scenario briefing

[INT 6, PERS 1] (…) if, just before entering when we were briefed about the game, you had mentioned something like ”Remember your communication, remember your closed-loop”, like if you had been reminded about those things. Do you not think that our communication would have been completely different in there?

 Learning objective in the escape room

[INT 5, PERS 1] (…) it (the escape room ed.) became more about the challenge, right. So in that way, I did not think much about it (the learning objective ed.) during.

 Combination of different learning modalities

[INT 5, PERS 1] (…) at the university then sometimes you just watch a lecture, and then that is what you get out of the teaching in some subject. Where here, it is like a three-pronged approach where you like watch it, then you try it, maybe unknowingly, and then afterwards talk about it and reflect. (…) I think it works very well in terms of learning.