Gamified learning during Ramadan: Feasibility, completion metrics, and learner perceptions in a virtual Beers Criteria escape room among PharmD students
DOI:
https://doi.org/10.46542/pe.2026.261.422429Keywords:
Cognitive performance, Perceived cognitive impairment, Pharmacy education, Ramadan fasting, Saudi Arabia, Student engagementAbstract
Background: Ramadan fasting affects sleep, energy, and cognition for millions of Muslims. Healthcare education concerns include scheduling cognitive assessments during fasting. Gamified methods like virtual escape rooms involve reasoning, collaboration, and time pressure. This study assessed the feasibility and student perceptions of a virtual Beers Criteria escape room during Ramadan among fifth-year PharmD students.
Methods: This study included 122 fasting fifth-year PharmD students who participated in a geriatric virtual escape room (G-VER) during Ramadan's third week. Metrics included completion time and hints used. A survey assessed concentration, problem-solving, confidence, sleep, energy, collaboration, and engagement. Subgroup analyses looked at gender differences.
Results: All students completed the activity within 90 minutes (100% rate). The average time was 32.4 ± 3.9 minutes, with 1.45 ± 0.95 hints used. Despite 69.7% reporting reduced concentration and 51.6% perceiving impairment during fasting, performance remained high. Most reported moderate energy (53.3%) and found the activity more enjoyable than traditional tests (73%). Female students completed faster (p < 0.001), but males showed higher confidence (p = 0.046).
Conclusion: Implementation of a complex, gamified pharmacotherapy assessment during Ramadan was feasible and well received. Although many students perceived cognitive challenges while fasting, students successfully completed the activity within the allotted time despite reporting perceived cognitive strain during fasting. These findings support the practical scheduling of interactive learning activities during Ramadan while highlighting the importance of addressing student perceptions of cognitive strain.
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