International Journal of Healthcare Simulation

Background and aim:

Gamification of learning is becoming increasingly popular within higher education [1]. Student activities described as ‘gameful training’, including Escape Rooms, have reported additional learner benefits including improved teamwork, creative thinking and communication skills compared to traditional session designs [2]. There is a small number of existing case studies demonstrating their utilization within healthcare professional education and the reported additional benefits included pertinent skills such as task delegation and leadership, as well as being an engaging teaching strategy that promotes active learning [3].

Activity:

A trial simulation escape room was created and implemented for level 5 adult and mental health branch nursing students within a Higher Education Institution. 12 different teams of students entered the escape room and worked together to ‘treat Arthur’, a patient presenting with acute anxiety and chest pain. Students were required to assess, escalate and manage Arthur effectively and would ‘escape the ward’, once he had received all of the required treatment.

The learning outcomes for the scenario and subsequent puzzles and tasks were created based on recent curriculum teaching allowing students to apply prior learning within the escape room environment. Puzzles included coded locked boxes and students were required to apply relevant knowledge, such as answering pharmacology questions, to generate codes and progress throughout the scenario. Simulation equipment was utilized and students unlocked clinical treatments and medical devices which in turn had to be delivered to Arthur. The facilitator maintained an active role within the scenario and allowed students to practise communication skills such as escalating their concerns about Arthur via the telephone.

It must be noted that the design time was significant for one scenario and required several pilots to ensure that all components were cohesive. Full support and creative input was required from the simulation technicians to ensure the activity’s success.

Findings:

Students fed back that they enjoyed the activity and were observed to work effectively together and prioritize and delegate throughout the task with minimal supervision. Students also stated the scenario context was helpful to apply their prior learning and were pleased that they had been able to manage this patient presentation together. Feedback from facilitators was also positive and both staff and students found it to be an engaging experience.

Conclusion:

Simulation escape rooms offer an innovative and engaging way for students to apply learning and vital practice technical and non-technical skills. For educators, clear learning outcomes and allowing sufficient design time is a necessity.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.