Using Generative AI to Enhance Clinical Prioritization and Cultural Competence of Students in Community Health Practice (IPE ER GenAI)

Using 'Interactive Escape Room Incorporated Generative AI' to Enhance Clinical Prioritization and Cultural Competence of Health Discipline Students in Community Health Practice - A Randomized Controlled Cross-over Study

This is a pragmatic, cross-over randomized, two-group pre & post-test experimental design aims to connect health discipline students from local and overseas countries to go through adventure-based escape rooms embedded with home setting scenarios.

Study Overview

• Status: Completed
• Conditions: Interprofessional Education; Generative AI
• Intervention / Treatment: Other: Virtual Escape Room

Detailed Description

To prepare health discipline students for effective interdisciplinary learning in a global learning environment, a novel pedagogical innovation is proposed in this project - using an interactive 'Escape Room' that encompasses situational and cultural awareness to enhance the delivery of appropriate prioritized care for community people in home setting. 'Escape room' is a game-based learning that shows evidence in motivating and engaging students in the learning process.

This project aims to connect health discipline students from local and overseas countries to go through adventure-based escape rooms embedded with home setting scenarios. The online rooms will be designed by the interdisciplinary teachers of involved institutions collaboratively, based on the concept of situational awareness that includes perception of the elements in the environment, comprehension of the situation, and projection of future status. To achieve the overall goal of developing prioritization skills and cultural competence skills of participating students, they will be empowered in mastering generative AI (ChatGPT) to acquire answers that pertain to specific scenarios, in which they need to analyze if the answers generated from AI are valid, helping them in prioritizing the solutions and resolving the situation correctly.

It is expected that interdisciplinary and intercultural learning among health discipline students from different regions will be enhanced, and therefore the development of their global citizenship through collaborative effort.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • 5/F, Academic Building, 3 Sassoon Road, Hong Kong

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• undergraduate healthcare students

Exclusion Criteria:

• cannot communicate in English and without internet access

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Initial intervention group (Group A); In the chronic obstructive pulmondary disease (COPD) module, Group A (intervention group) will go through the ER COPD scenario with group discussion. The tuberculosis (TB) module launched after three weeks of washout period, Group A (control group) will go through the TB scenario using problem based learning approach.	Other: Virtual Escape Room; To prepare health discipline students for effective interdisciplinary learning in a global learning environment, a novel pedagogical innovation is proposed in this project - using an interactive 'Escape Room ER' that encompasses situational and cultural awareness to enhance the delivery of appropriate prioritized care for community people in home setting. 'Escape room' is a game-based learning that shows evidence in motivating and engaging students in the learning process. The online rooms will be designed by the interdisciplinary teachers of involved institutions collaboratively, based on the concept of situational awareness that includes perception of the elements in the environment, comprehension of the situation, and projection of future status. To achieve the overall goal of developing prioritization skills and cultural competence skills of participating students, they will be empowered in mastering generative AI (ChatGPT) to acquire answers that pertain to specific scenarios.
Experimental: Initial control group (Group B); In the chronic obstructive pulmonary disease (COPD) module, Group B (control group) will go through the COPD scenario using problem based learning approach. The tuberculosis (TB) module launched after three weeks of washout period, Group B (intervention group) will go through the ER TB scenario with group discussion.	Other: Virtual Escape Room; To prepare health discipline students for effective interdisciplinary learning in a global learning environment, a novel pedagogical innovation is proposed in this project - using an interactive 'Escape Room ER' that encompasses situational and cultural awareness to enhance the delivery of appropriate prioritized care for community people in home setting. 'Escape room' is a game-based learning that shows evidence in motivating and engaging students in the learning process. The online rooms will be designed by the interdisciplinary teachers of involved institutions collaboratively, based on the concept of situational awareness that includes perception of the elements in the environment, comprehension of the situation, and projection of future status. To achieve the overall goal of developing prioritization skills and cultural competence skills of participating students, they will be empowered in mastering generative AI (ChatGPT) to acquire answers that pertain to specific scenarios.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Technology-Enabled Active Learning (TEAL)	Students' perceptions of the technology-driven learning environment were measured using the TEAL instrument (Shroff et al., 2019). This validated survey assesses how students experience active learning when supported by technology. It focuses on four key dimensions: Interprofessional Teamwork (ITR), Prioritization (PRS), Intervention (INT), and Feedback (FEE). The total TEAL score provides a comprehensive view of the students' ability to collaborate and manage tasks effectively within a digital learning framework.	2 months
Students Perceptions of Interprofessional Clinical Education Revised (SPICE-R)	The SPICE-R instrument contains ten items and three factors dedicated to interprofessional teamwork and team-based practice (items 1, 5, 6, & 8-10), roles/responsibilities for collaborative practice (items 2 & 7), and patient outcomes from collaborative practice (items 3 & 4). The SPICE-R instrument demonstrated reliability and construct validity. The instrument demonstrated validity according to multiple established criteria, and the composite reliability of the overall instrument (i.e., all ten items evaluated together) was high at 0.84.	2 months
Online Student Engagement questionnaire (OSE)	The questionnaire comprised four factors, namely skills engagement (e.g., taking good notes over readings), emotional engagement (e.g., finding ways to make the course interesting to me), participation engagement (e.g., participating actively in small group discussion forums), and performance engagement (e.g., getting a good grade). The Online Student Engagement (OSE) covered 19 items that measured students' behaviours, thoughts, or feelings regarding the online courses. The items were scored using a 5-point Likert scale. The OSE requires approximately 10-15 min to complete. The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement and performance engagement were 30, 25, 30 and 10 respectively. A mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The OSE exhibited face and concurrent validity and had a Cronbach's Alpha of 0.91.	2 months
Modified Cultural Awareness Scale (mCAS)	The mCAS is a four-factor measure of cultural awareness, and it possesses satisfactory internal consistency. The Cronbach's alpha value was 0.88 for the total scale and ranged from 0.7 ("cognitive awareness") to 0.9 ("general educational and research experience") for the four subscales. The four factors explained 43.4% of the total variance. All items had a factor loading > 0.3. Factor 1, "general education and research experience," included 15 items and was the strongest factor (16.87% of the total variance). Factor 2, "behaviours/comfort with interactions," included eight items. Factor 3, "cognitive awareness," and factor 4, "clinical issues", included 7 and 5 items. Results support the use of the modified CAS as a generic tool to measure cultural awareness among students in higher education within the health and social care fields.	2 months

Collaborators and Investigators

• Sponsor: The University of Hong Kong

Publications and helpful links

General Publications

• Kumlien, C., Bish, M., Chan, E. A., Rew, L., Chan, P. S., Leung, D., & Carlson, E. (2020). Psychometric properties of a modified cultural awareness scale for use in higher education within the health and social care fields. BMC medical education, 20(1), 406-408. https://doi.org/10.1186/s12909-020-02326-8
• Dixson, Marcia. (2015). Measuring Student Engagement in the Online Course: The Online Student Engagement Scale (OSE). Online Learning. 19. 10.24059/olj.v19i4.561.
• Dixson, M. D. (2010). Creating effective student engagement in online courses: What do students find engaging? Journal of Scholarship of Teaching and Learning, 10(2), 1-13. Retrieved from http://josotl.indiana.edu/article/view/1744
• Dominguez DG, Fike DS, MacLaughlin EJ, Zorek JA. A comparison of the validity of two instruments assessing health professional student perceptions of interprofessional education and practice. J Interprof Care. 2015 Mar;29(2):144-9. doi: 10.3109/13561820.2014.947360. Epub 2014 Aug 7.

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2025
• Primary Completion (Actual): October 31, 2025
• Study Completion (Actual): October 31, 2025

Study Registration Dates

• First Submitted: April 15, 2026
• First Submitted That Met QC Criteria: April 15, 2026
• First Posted (Actual): April 22, 2026

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 22, 2026
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: Interprofessional education; Generative AI; Virtual Escape Room
• Other Study ID Numbers: EA250198; 962 (Other Grant/Funding Number: HKU)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No