A Digital Escape Room to Teach Medical and Veterinary Students About Antimicrobial Resistance Using the One Health Approach

NCT07848217 | Completed

• 1 other identifier: Project No: 949327100
• Study Type: interventional
• Target: 300
• Locations: 2 countries
• Sites: 3

Brief Summary

The goal of this clinical trial is to evaluate the effectiveness of a One Health-based educational intervention in final-year medical students from two universities in Norway and Zambia. The main question it aims to answer is:

1. 1.Does AMRageddon improve total AMR knowledge scores, particularly in clinical case reasoning, compared with traditional lectures?
2. 2.Does AMRageddon enhance students' awareness of AMR and One Health principles more effectively than lectures?
3. 3.Attend either a gamified interactive session (AMRageddon) or a standard lecture-based session on AMR.
4. 4.Complete a baseline questionnaire assessing AMR knowledge, awareness, and behaviour.
5. 5.Complete a follow-up questionnaire one month after the educational session to evaluate changes in outcomes.

Conditions

Antimicrobial Resistance (AMR)

Outcome Measures

Primary Outcomes (1)

• Change in the knowledge, attitudes, and perception of participants towards antibiotics and One Health.

  A pre- and post-test will be shared to the students prior and after the intervention. This will be in the format of a questionnaire. The primary outcome was a knowledge test with 24 questions with subsections including clinical decision making skills assessment (8 questions), knowledge (4), awareness (4) and behaviour assessments (4). A correct score was awarded 1 point.

  Baseline and 4 weeks post-intervention.

Secondary Outcomes (1)

• User-experience and System Usability Scale Surveys

  Immediately completing AMRageddon

Study Arms (2)

Intervention Group

EXPERIMENTAL

Medical and Veterinary students will be asked to use AMRageddon in place of attending a standard pre-established lecture during their academic training. They will be asked to complete a baseline questionnaire, and a questionnaire following the intervention set 4 weeks later.

Other: AMRageddon

Control Group

NO INTERVENTION

Students will receive the standard format of learning of AMR and One Health during their lecture. They will have to complete a baseline questionnaire and a follow up questionnaire 4 weeks after the intervention.

Interventions

AMRageddon OTHER

AMRageddon is a digital escape room game created by the research team. The app uses gamification and game-elements to increase user engagement and to deliver information to partiapnts. AMRageddon is based on the WHO Health Workers Education and Training on Antimicrobial Resistance Curricula Guide and WHO Competency Framework for Health Workers' Education and Training on Antimicrobial Resistance.

Intervention Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Above the age 18 years
• Have access to internet
• Have access to a laptop, tablet or phone
• Must be enrolled at either NMBU, NTNU or LAMU

You may not qualify if:

• Below the age 18 years
• Not enrolled at either of the pre-determined institutions

Sponsors & Collaborators

• University Teaching Hospital, Lusaka, Zambia: collaborator
• Norwegian University of Science and Technology: lead
• Norwegian University of Life Sience (NMBU): collaborator

Study Sites (3)

Norwegian University of Life Sciences (NMBU)

Ås, Oslo, Norway

Location

Norwegian University of Science and Technology

Trondheim, Trøndelag, Norway

Location

Lusaka Apex Medical University

Lusaka, Lusaka Province, Zambia

Location

Related Publications (1)

• Nowbuth, A.A., Parmar, V.S., Elizo, A.P., Steinsbekk, A.I., Parmar, A.J. (2025). AMRageddon V1: The Design and Usability Evaluation of a Digital Escape Room Game for Antimicrobial Resistance Education Through Persuasive Technology. In: Win, K.T., Ali, R., Karapanos, E., Papadopoulos, G.A., Oyibo, K., Vlahu-Gjorgievska, E. (eds) Persuasive Technology. PERSUASIVE 2025. Lecture Notes in Computer Science, vol 15711. Springer, Cham. https://doi.org/10.1007/978-3-031-94959-3_18

  BACKGROUND

Related Links

• Official website from NTNU

Study Officials

• Vikram P Singh, PhD

  Norwegian Univeristy of Science and Technology (NTNU)

  STUDY CHAIR

• Aslak I Steinsbekk, PhD

  Norwegian Univeristy of Science and Technology (NTNU)

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 26, 2025
• First Posted: September 29, 2026
• Study Start: September 4, 2024
• Primary Completion: February 11, 2025
• Study Completion: February 15, 2025
• Last Updated: September 29, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

NO (2); ZA (1)