Abstract
BACKGROUND: Intern physicians, in the final stage of medical training, face increasing clinical responsibility and workload, which may heighten vulnerability to errors and second victim experiences. This study aimed to explore interns’ second victim experiences using an escape-room–based educational intervention and to examine the emotional and systemic dimensions underlying these experiences. METHODS: A mixed-methods design was employed. Sixty-six Year 6 medical students in the Emergency Medicine rotation at XXX University Faculty of Medicine participated. Interns who voluntarily attended the escape-room activity and structured reflection session (n = 33) were compared with those who did not participate but completed the quantitative assessment (n = 33). Quantitative data were collected using the Second Victim Experience and Support Tool–Revised (T-SVEST-R), and qualitative data were derived from reflection transcripts. RESULTS: A statistically significant difference was observed in perceived organizational support, with higher scores in the intervention group compared with the comparison group (p < 0.05). Although psychological distress scores were lower among interns who participated in the escape-room activity, this difference did not reach statistical significance. Qualitative findings indicated that the gamified and reflective process made emotional experiences more visible and shareable, strengthened team identity, and increased awareness of systemic and interpersonal dimensions of second victimization. Themes included emotional confrontation, peer support, coping through reflection, and recognition of structural challenges within clinical training. CONCLUSION: The integration of experiential learning and structured reflection through an escape-room approach can effectively address second victimization by fostering resilience, emotional awareness, and compassionate teamwork among medical interns. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-026-09033-w.