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Introduction Physical distancing guidelines during the coronavirus disease 2019 (COVID-19) pandemic forced medical residency programs to move a large portion of required didactics to virtual settings Toxicology, a core component of emergency medicine (EM) education, was forced to adapt to similar constraints An in-person escape room style puzzle was modified to a virtual format for educational purposes, and shared with and evaluated by two different residency programs Materials and methods A virtual escape room, \'Escape the Toxin: Online!\' was created to test knowledge of toxicologic ingestion and antidote utilizing Google Forms and delivered using Zoom teleconference software to two EM residency programs in the Philadelphia region After small groups completed the gamified activity, their scores were calculated and they completed an anonymous evaluation Results Residents at the program where a Medical Toxicology fellowship is located found the virtual escape room to be more effective and enjoyable compared to the second program Despite some differences in perceived effectiveness, the majority of participants were able to correctly solve the puzzle and get to the antidote Conclusion The majority of learners who participated from both residencies agreed that they would recommend this virtual program to other EM residents
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