EscapeIF: Neurological Circus

Presenter: Jennifer Carmack, University of Indianapolis Neuro Circus is an interactive, choose-your-own-path classroom simulation designed to strengthen clinical judgment, pattern recognition, and prioritization under time pressure. In this activity, students are placed in a fictional circus environment where performers present with deliberately vague neurological symptoms representing conditions such as Guillain-Barré syndrome, myasthenia gravis, ALS, Parkinsonian disorders, trigeminal neuralgia, Bell’s palsy, and multiple sclerosis. Students must work as a group to decide which performer to assess first, triggering branching pathways with progressively revealed assessment data. Incorrect prioritization results in time penalties and clinical deterioration, mirroring real-world consequences of delayed recognition. The simulation emphasizes subtle indicators of respiratory compromise—such as fluctuating voice strength, fatigability, weak cough, and decreased breath count—rather than overt respiratory distress. A surprise acute neurological flare is introduced to challenge anchoring bias and reinforce the importance of reassessment. Structured debriefing focuses on emotional processing, cognitive traps, airway prioritization, and NCLEX-style clinical reasoning. Neuro Circus requires no specialized simulation equipment and can be implemented in a one-hour class using PowerPoint branching slides, student worksheets, and a facilitator guide. Preliminary classroom implementation has demonstrated high student engagement, improved prioritization confidence, and increased recognition of early neuromuscular respiratory risk. This presentation will outline activity design, implementation strategies, facilitator scripting, and debriefing techniques, offering a scalable model for transforming complex neurological content into an immersive, high-impact learning experience.