The research proceeded in two phases. First, investigators conducted semi-structured interviews with 25 experts in e-learning, educational technology and health sciences education. Participants were selected through purposive and snowball sampling, and conventional qualitative content analysis was used to identify the framework’s core components. A separate panel of 10 experts then structured the extracted components through Interpretive Structural Modeling and DEMATEL. The researchers assessed the content validity and applicability of the resulting framework with another group of 15 experts using a researcher-developed questionnaire. The study therefore combined qualitative interviews, expert-based modeling and questionnaire evaluation; it did not test the framework through a classroom intervention or measure student learning outcomes.

The analysis placed the 14 components into four hierarchical levels. The foundational level consisted of three relatively independent drivers: interpersonal learning objectives, technical infrastructure and contextual adaptation. A mutually dependent core design cluster included individual learning objectives, scenario and puzzle design, group interactions, in-game feedback, motivational mechanisms, digital media and user-interface design. Scalability formed the next level, while assessment and feedback and the educational-game ecosystem were placed at the most dependent level. This structure portrays virtual escape rooms as layered socio-technical instructional systems in which instructional, experiential, technical and contextual elements are interdependent rather than independently selectable features.

Data security and privacy recorded the highest net influence in the expert modeling but had no strong link to any single component, leading the researchers to characterize them as a cross-cutting requirement. The framework also connects learner-facing design elements such as feedback, interaction and assessment with institutional infrastructure, local context and relationships among learners. Its favorability ratings reflect expert judgment rather than observed performance in real educational environments. The authors’ conclusion is therefore bounded: the study provides a theoretically informed, expert-derived structure for designing virtual escape rooms in health sciences education, while the next stage of evidence must come from implementation studies and external validation in authentic settings.

Subject of Research: Expert-derived framework for designing virtual escape rooms in health sciences education

Article Title: Development of an integrated framework for designing virtual escape rooms in health sciences education

Article References: Raoufian, H., Mirmoghtadaie, Z., Zarrabi, H. H., & Toofaninejad, E. (2026). Development of an integrated framework for designing virtual escape rooms in health sciences education. BMC Medical Education. https://doi.org/10.1186/s12909-026-10685-x

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10685-x

Keywords: virtual escape rooms, health sciences education, instructional design, e-learning, educational technology, gamification, mixed-methods study, expert modeling, data privacy, expert validation, Development, integrated