The popularity of escape rooms has grown exponentially in the past decade, with these simulated group activities becoming an established part of gaming and pop culture. But the concept offers more than just a fun distraction or chance to work cooperatively with friends and family. Increasingly, these games are being incorporated into simulation-based clinical education.

An opportunity for collaboration.

In an escape room activity, a group of people work together to find clues, solve puzzles, and complete tasks within a set period of time. As they do so, they may progress through one room or several, but the goal is typically the same: for the group to “escape” from a simulated situation.

Step-by-step guide.

Educators have been exploring the use of this approach in nursing education to reinforce knowledge and engage students. As nurse educator Janice Hawkins and her colleagues at Old Dominion University School of Nursing in Virginia point out:

“By requiring a group of learners to solve a series of skills-related puzzles, educational escape rooms can help to build critical thinking, communication, and cooperative problem-solving skills.”

In “Behind the Scenes of an Educational Escape Room,” they provide a step-by-step guide to developing an effective educational escape room. Their advice stems from their yearlong experience developing, piloting, implementing, and evaluating an escape room game for first-year nursing students. Their activity takes place in their school’s simulation lab, with students working together to locate clues, solve puzzles, and communicate successfully to safely administer medications.

‘An effective way to practice skills.’

According to Hawkins and colleagues, 90% of participants have felt that the escape room simulation was an effective way to practice skills related to safe medication administration. They note that their activity has also attracted attention from diverse groups of nurses, including alumni who saw the school’s social media posts about the escape room and attendees at a national nursing conference, where the authors demonstrated their simulation:

“Nurses told us they valued the opportunity to practice their skills in a nontraditional setting. Nurse educators affirmed the value of using this teaching strategy, and clinical nurse educators identified the applicability of such a model in reinforcing hospital medication administration policies during orientation programs for newly graduated nurses and new hires.”

Tips for success include creating a ‘meaningful narrative.’

Among the practical advice and insight Hawkins and her colleagues provide is a recommendation that educators create an escape room narrative that is meaningful to students. Their story revolves around their school’s beloved and retired mascot, Big Blue, who, according to the narrative, was admitted to the hospital after celebrating the biggest win in their school football team’s history. In the activity, nursing students “escape” the room after completing clinical tasks that allow Big Blue to be discharged in time for a victory parade.

Game planners should spend some time thinking about local or current events that can have a unifying effect on escape room participants. Additionally, keeping the story line fun and entertaining offsets some of the pressure and anxiety participants might feel about the tasks they have to perform.

At the same time, Hawkins and colleagues note, nurse educators may find they enjoy the process of developing such a learning activity:

“Before developing this educational game, it may be useful for the planning team to participate in a recreational escape room activity to gain a better understanding of the various types of clues and the way in which this game typically unfolds. A field trip to a local escape room facility was a fun and informative activity for us.”

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