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AIM: The present study was conducted to determine the effect of education provided to first-year nursing students with the escape room game on their learning of parenteral drug administration. BACKGROUND: The use of escape room games in education supports formal education in providing students with professional knowledge and skills. DESIGN: A randomized controlled study design was used in this study. METHOD: The current study was conducted with 72 first-year nursing students. Data were collected with the Descriptive Characteristics Questionnaire (DCQ), Parenteral Drug Administration Information Test (PDAIT), Parenteral Drug Administration Sub-Checklists (PDASC) and Game Evaluation Form (GEF) between May and June 2022. The initial knowledge and skills of all students participating in the study were measured after completing the parenteral drug administration theoretical course and laboratory skills course. Students were assigned to the intervention (n=36) and control (n=36) groups by the stratified block randomization method according to their initial knowledge and skill measurements. Unlike the control group, the intervention group played the escape room game once in groups of four. The control group was allowed to work freely in the laboratory during this period. The final knowledge and skills of the intervention and control groups were measured immediately after the intervention. Students' skills were measured with an objective structured clinical examination. RESULTS: It was determined that the post-test knowledge level of the students in the intervention group and their post-test skill mean scores for drug withdrawal from an ampoule, subcutaneous injection administration, intradermal injection administration and intravenous push drug administration were higher than those of the students in the control group (p<0.05). Additionally, Intervention group students evaluated the escape room game positively. CONCLUSION: This study concluded that the escape room game supported formal education and could be used in teaching parenteral drug administration.

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An educational escape room is a form of game-based learning that has been shown to improve students' learning experience. A cardiovascular escape room was designed to promote the development of transversal skills and help students retain learned content knowledge in an integrated pharmacology and therapeutic unit in a Pharmacy course. OBJECTIVE: This study aims to design, pilot, and evaluate the students' self-perceived transversal skills, learning experience and knowledge acquisition from a cardiovascular educational escape room. METHODS: The model pharmacy at Curtin University was used as the room that students were challenged to escape. Students were required to acquire a four-digit safe code, with each digit derived from four separate briefcases containing different puzzles and clues. This code enabled students to unlock a lifesaving medication to successfully escape the room and rescue a fictional patient who had collapsed outside of the pharmacy. Each session was followed by a debrief to reflect on the learning experience. RESULTS: Fifty-four students participated in the study. Eight out of twelve groups successfully escaped the room. There was negligible difference in the score of the pre- and post-knowledge assessments. All students strongly agreed/agreed that the escape room was an effective way to review the cardiovascular content covered in the lecture and tutorial and that the activity should be continued for future students. CONCLUSION: Students perceived the education escape room as a valuable learning exercise to help them retain content knowledge and develop transversal skills in the learning of integrated pharmacology and therapeutic within a Pharmacy course.

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BACKGROUND: Clinical evaluation utilizing the escape room game is recognized as a novel method for assessing the team-oriented performance of learners. It is a tool for evaluating teamwork skills in clinical settings, which can boost student motivation and learning. This study aimed to investigate the effect of clinical evaluation through escape rooms and feedback provision through the PEARLS (promoting excellence and reflective learning in simulation) approach on pre-internship nursing students' satisfaction, learning, and preparedness to practice as interns. MATERIALS AND METHOD: The current research is a quasi-experimental quantitative study conducted with a census sample of 42 sixth-semester undergraduate nursing students in 2022. The escape room method was utilized to evaluate entry preparedness into the clinical field. Reliable and valid researcher-made questionnaires were administered to assess the impact of the intervention on learning, satisfaction, and preparedness. The data were analyzed in SPSS version 26 using descriptive and inferential tests. The significance level was considered to be less than 0.05. RESULTS: Twenty-six males and 16 females constituted the 42 participants (mean age: 23.46 years). The clinical evaluation method of the escape room game was deemed satisfactory or highly satisfactory by 80% of students. From the perspective of 72% of students, escape rooms were definitely or highly effective in shaping their preparedness to enter the clinical field. Comparing the students' mean learning scores (self-assessment of clinical skills) before and after the test revealed that their post-test scores (55/16 ± 13/33) were significantly higher than their pre-test scores (45/58 ± 16/58) (P < 0.001). CONCLUSIONS: It appears that using the escape room evaluation method in conjunction with other student evaluation methods has helped improve students' interpersonal communication, problem-solving skills, critical thinking, and teamwork. The experience of working in a group not only improves these skills and is enjoyable to students but can also enhance their learning. Clinical education is dependent on teamwork. The escape room test can be viewed as a valuable tool for encouraging students to collaborate as a team. Therefore, it is suggested that students in all medical education groups be evaluated clinically using this test.

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The primary goal of this meta-analysis is to explore the five factors of knowledge, teamwork, learning satisfaction, anxiety, and interprofessional ability to determine the value of escape rooms in medical education. Up to January 2023, we searched ScienceDirect, Scopus, PubMed, Embase, Web of Science, CNKI, and the Cochrane Library for pertinent works in either English or Chinese. The Risk of Bias 2 (RoB 2) tool and Newcastle-Ottawa Scale (NOS) were used to assess the quality of studies. Subgroup and sensitivity analyses were used to assess statistical heterogeneity, and I2 was used to measure it. Overall, escape rooms had a more significant positive effect than traditional learning on knowledge (standardized mean difference [SMD]: 0.84; 95% confidence interval [CI]: 0.36-1.33), teamwork (SMD: 4.91; 95% CI: 4.58-5.24), learning satisfaction (MD: 0.36; 95% CI: 0.08-0.64), and interprofessional ability (SMD: 1.04, 95% CI: 0.81-1.27). Moreover, the impact of escape rooms on anxiety also had significant effects (SMD: -8.23, 95% CI: -11.64 to -4.82). Escape rooms affect medical students' knowledge, teamwork, learning satisfaction, interprofessional ability, and anxiety. The findings of this study can be used as evidence that escape rooms is a more effective method than traditional teaching for improving active learning.

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BACKGROUND: Educational escape games have become more common, yet their effectiveness needs to be evaluated to establish whether or not they are a constructive pedagogical tool. AIM: This study explored students' experiences of a general practice (GP) based escape game to uncover whether it deserves a place in a medical school's curriculum. DESIGN AND SETTING: A mixed methods case study within one Scottish Medical School. METHOD: Data were collected during March 2020 via 32 video recordings of an Escape Room Game, combined with participant, post-game questionnaire analysis. Video footage was reviewed in an ethnographic manner and thematic analysis conducted. RESULTS: Fourteen team events constituting 718 minutes were analysed. From the footage, five themes with fourteen subthemes emerged. The five main themes were: teamwork, leadership, clinical thinking, numeracy, and gamification. From the student questionnaires (n = 131), it was reported that the GP escape room was predominantly an extremely positive educational experience. CONCLUSION: Educational escape games appear invaluable in medical education. They can promote the growth of non-technical skills such as teamwork, leadership, and clinical thinking; all essential to working in a multidisciplinary team and enabling patient safety. Our participants struggled with numeracy in this high-pressured environment, this must be addressed to reduce potential mistakes made in the workplace. Results are supportive of educational escape games being worthy of a space within a medical school's curriculum. A GP-orientated escape room allows for early GP exposure from a different perspective, as well as equipping students with the skills to be successful in this field.

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ANNA's Administration SPN created this proposal as a clinical practice project to re-evaluate how training and education are provided to individuals working in the dialysis setting. This article describes an education initiative based on the escape room methodology to provide a fresh approach on dialysis curriculum.

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BACKGROUND: The evolving healthcare landscape necessitates highly qualified nurses equipped with a myriad of soft skills, including decision-making. Traditional teaching models have led to innovative, active methods that prioritise student participation and enhance crucial soft skill development, such as decision- making. Considering the recognised importance of improving clinical decision-making skills and the need for innovative training, a literature gap is present in assessing the effect of real world and game-based learning on decision-making abilities. OBJECTIVES: This study aimed to investigate the effect of real-world and game-based learning, specifically using case-based learning and escape room, on decision-making competence in postgraduate nursing students in academic and clinical settings. DESIGN: A descriptive, cross-sectional, quantitative intervention study was conducted, combining case-based learning and escape room methods sequentially. SETTINGS: The study was conducted among postgraduate nursing students at the University of Navarra in Spain. PARTICIPANTS: Sixty-six postgraduate nursing students, mostly women, participated in the study. METHODS: The study integrated case-based learning and escape room sequentially. Data were collected through an ad hoc online questionnaire, recorded escape times from the escape room, and academic scores. RESULTS: The study enrolled 66 participants with an average professional experience of 4.2 years. Academic results showed high scores in case resolution (average: 8.34) and knowledge tests (average: 9.21). Out of 11 groups, 81.8 % successfully escaped the escape room within 30 min, with positive questionnaire responses indicating enthusiasm, enjoyment and perceived effectiveness of the activities. CONCLUSIONS: Real-world and game-based learning significantly enhanced decision-making competence in postgraduate nursing students across academic and clinical settings, demonstrating the importance of diverse teaching methods. Further research, including comparative studies and longitudinal analyses, is needed to evaluate the educational benefits of integrating case-based learning and escape room methods in nurse education and to refine assessment tools while monitoring long-term student progress.

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Background: High-stakes yet clinically infrequent procedures are challenging to teach. Escape rooms may offer an innovative solution through game-based learning. There is limited guidance on how to design an escape room focused on physical puzzles. We designed and implemented a procedure-focused escape room to teach high-stakes procedures to anesthesiology residents. Methods: We selected 5 procedural skills relevant to anesthesiology residents through a modified Delphi technique: fiberoptic intubation, rapid infuser setup, intraosseous line placement, flexible bronchoscopy, and supraglottic airway exchange. We designed associated skills stations and linked them in sequence using an elaborate series of puzzles, locks, keys, and codes. The total cost of puzzle equipment was $169.53. After pilot testing, we implemented the escape room from July to November 2022. We assessed residents using a single group pretest-posttest study design. Results: Forty-three of 55 (78%) eligible anesthesiology residents participated in the escape room. Thirty-one residents completed the surveys. Resident self-efficacy significantly improved for each of the 5 procedures. Twenty-six of 27 (96%) residents preferred the escape room over a typical procedural skills workshop. Conclusions: This pilot study demonstrated the feasibility of a procedure-focused escape room for teaching high-stakes technical skills. We identified 3 lessons in procedure-focused escape room design: set participant caps intentionally, optimize resource usage, and maximize reproducibility. Participating in a single escape room session significantly increased resident self-efficacy. Residents strongly preferred the escape room format over a traditional procedural skills workshop.

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The conventional mode of medical education is delivered using didactic lectures, wherein teachers disseminate the desired information to a large number of students in a structured manner. The purpose of the current review is to explore the scope and need of escape rooms in medical education and identify the potential considerations to be acknowledged while designing an escape room in a medical college for training undergraduate medical students. Escape rooms in principle refer to the learning environments that are interactive and immersive, in the sense that students who are part of these rooms are posed with a puzzle or a challenge or a task that must be solved by them within a defined period of timeframe to eventually escape from the room, which is the ultimate goal of such sessions. The success of escape rooms is determined depending by the way it has been designed, in terms of their ability to engage the involved participants and promote collaboration. In conclusion, the employment of escape rooms in medical education is an innovative teaching-learning method to overcome the limitations of conventional strategies. Acknowledging the merits of escape rooms in the development of critical thinking and teamwork skills, it is the need of the hour that every medical institution must explore the possibility and introduce it within their settings to ensure experiential and long-term learning among medical students.

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OBJECTIVE: To evaluate the efficacy of an educational intervention (escape room) in the acquisition and retention of knowledge in relation to the Infarction Code, and to compare the knowledge of other teaching methodologies related to the Infarction Code. METHODS: A pre-post study was designed without a control group. After one month of the master class on the Infarction Code given to master's degree (doctors and nurses), an educational intervention was carried out consisting of an Escape Room on the same content, with a questionnaire that collected various sociodemographic data, and a knowledge test on the Infarction Code, which was repeated immediately after the activity and at the end of 2 months after the activity, and a test of knowledge on the Infarction Code. immediately after the activity and 2 months after the master class. Likewise, after the activity, a gamified experience evaluation questionnaire (GAMEX) was completed. RESULTS: Thirty-two students received the educational intervention (12 physicians and 20 nurses), and differences were observed between medical and nursing professionals in terms of initial knowledge of simulation and gamification. After the activity, and based on the initial knowledge test, the score increased by 3.49 points, an increase that was also reflected in the test taken two months after the master class, where an increase of 2.08 points was maintained. The participants rated the experience positively, with no significant overall differences between the two professional groups. CONCLUSIONS: The nurses had greater knowledge and contact with clinical simulation, virtual reality and gamification. The escape room showed to be a valid method for the assimilation and retention of knowledge in master's degree students. Medical professionals experienced a greater degree of immersion in the activity.

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Escape rooms in medical education are relatively a novel approach to facilitate critical thinking and decision-making in simulated realistic clinical scenarios among the medical students. The success of escape rooms in the attainment of specified competencies depends on several factors that must be given due consideration for optimizing the overall outcome. Further, there might be multiple ethical concerns that must be given due attention before, during, and after the conduct of such sessions. There is an immense need to integrate ethical considerations while designing and implementing escape rooms in medical schools, as it will aid in the creation of a respectful and encouraging learning atmosphere for the students. In conclusion, escape rooms provide a great learning opportunity for medical students to critically think, engage in teamwork, and learn the art of adaptation depending on the given clinical scenario. However, the successful conduct of such sessions is determined by a wide range of factors, including ethical considerations, and all of them need to be systematically analyzed and measures should be taken to reduce their impact on students.

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BACKGROUND: Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants' experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing. METHODS: In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned "exchange of information" and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation. RESULTS: Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach. CONCLUSIONS: Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students. CLINICAL TRIALS: Clinical.trials ID NCT04783259.

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An escape room is a team-based activity that requires players to solve a series of puzzles to complete a story and "break out" of a room. It has recently gained traction in medical education for its ability to interactively and effectively present learning objectives. This was a prospective educational study that describes the successful application of a nephrology themed escape room for first- and second-year medical students. Compared to pre-escape room participation, the 52 students demonstrated a statistically significant improvement in self-reported knowledge for renal physiology (p < 0.01), pharmacology (p < 0.01), pathology (p < 0.01), and relevant clinical practice guidelines (p < 0.01). A majority of the students also claimed that the escape room was "more effective" than traditional lectures (80.8%) and textbooks (73.1%) and "equally effective" as third-party board preparation resources (69.2%) and their institution's problem-based learning curriculum (51.9%). The escape room also facilitated a high-level peer-to-peer collaboration with 82.7% and 76.9% of students reporting that they worked with someone in their year and outside of their year for at least half of the game, respectively. Ninety-five percent of the first-years and 84.6% of the second-years believed that the escape room was effective at preparing them for their respective exams, and an overwhelming majority (90.4%) described the escape room as "very enjoyable." Overall, this nephrology themed escape room was an engaging and well received educational modality and may be an effective supplemental study resource for medical students. Further studies are needed to assess knowledge acquisition. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01917-6.

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PURPOSE: The purpose of this scoping review is to assess the literature on allied health professions escape rooms (AHPERs), investigating their common purposes and practices, and the trends in scholarship. METHODS: This scoping review followed PRISMA-ScR guidelines to assess the size and scope of evidence in the literature, categorize common purposes and practices, and explore trends in AHPER scholarship. Two reviewers developed a review protocol, collected literature using a search strategy aligned with inclusion criteria, and charted review results. RESULTS: The literature search yielded 6,170 articles. After the final review, 34 unique records met inclusion criteria. Studies were conducted in the United States, Spain, Australia, France, Brazil, and Canada. Most escape rooms reported participants, team size, puzzle type, and outcomes, but few used causal research designs, primarily using pre-post with no control designs. AHPERs represent an increasingly popular pedagogical approach. AHPERs tend to be simply structured, patient themed, and convey either disciplinary or interprofessional lessons. Generally, AHPERs were self-reported as effective and satisfying, but scholarship supporting AHPERs was insufficient in design for causal claims. CONCLUSION: Developers and scholars may benefit from considering frameworks and guidelines for consistent creation and increased trustworthiness in the AHPER practice and knowledge base. Where AHPER scholars can increase attention to learning outcomes, and plan scholarly works in advance of the escape room, the AHPER body of knowledge will increase.

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To determine the usefulness of combining two methodologies (OSCE and escape room) in a scenario simulation to evaluate a subject, and determine the evaluation of the students of this experience. An observational cross-sectional study was carried out with students enrolled in a sexual and reproductive health-care course as a part of their nursing degree. The students had to solve four clinical cases based on the contents of the teaching practices of the subject by solving clues that led them to carry out procedures and techniques and provide care in scenario simulators. Students evaluated the experience using the GAMEX (Gameful Experience in Gamification) scale. Mean differences were estimated with their respective 95% confidence intervals. A total of 124 students participated. Of these, 63.7% (79) solved the clinical cases with their knowledge and skills. Most (80.6%, 100) students stated that they completely remembered and applied the knowledge of the topic during the game. Almost all (98.4%, 122) would recommend this experience. The dimensions with the best rating on the GAMEX scale were "fun", with an average score of 4.7 points (0.49), followed by "critical thinking", with 4.2 (0.59). Women presented statistically better scores than men (mean difference: 1.58; 95% CI: 0.55, 2.61). The OSCE combined with an escape room using scenario simulations may be a useful tool to evaluate the subject. In addition, the students were satisfied, had fun, and recommended the experience. This study was not registered.

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INTRODUCTION: The benefit of pedagogical escape rooms for dental students' stimulation, interest and knowledge strengthening has been suggested by several studies. However, in previous studies, only a few students were evaluated. This study aims to confirm the purpose of this innovative pedagogical tool in terms of learning consolidation and team building from students' perceptions. We directly incorporated an educational escape game into the fundamental academic formation as a practical-work course for fifth-year dental students. MATERIALS AND METHODS: The present escape game focused on 3D printing, whose implementation fit the different steps of an escape game well. This study was conducted in March 2022. All fifth-year dental students (n = 212) were divided into 5-6 student groups to match the conditions of an escape game. Before entering the room, each student had to complete a cross-sectional knowledge true/false test of 8 questions to assess their general level. Additionally, an 18-question appreciation survey was completed when leaving the room. RESULTS: The students perceived the 3D-printing escape game to be relevant and especially expressed the benefit of being part of a team to exchange and build knowledge. These results suggest knowledge strengthening. The instructional benefit of this process seemed to exceed its mere fun and appealing aspect. CONCLUSION: Our results with a large number of students showed that, from the students' perception, the educational escape game significantly improved knowledge and team-building. It created a supportive learning environment and increased students' motivation. It can provide a fun and effective way to diversify instruction.

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The dataset aims to examine the prior and acquired knowledge in an Escape Room (ER) experience on sustainable mobility. In addition, the data could also be used to identify possible correspondences between some mobility behaviors and the predisposition to learn sustainable mobility concepts to foster attitude change. To meet these objectives, an ER on sustainable mobility was conducted and a questionnaire was given before and after the activity to 173 students from various schools between 5th grade of primary school and 1st year of compulsory secondary school (10-13 years old). The questionnaire was divided into two parts. The first part included social demographics questions (gender, family members, place of residence) and mobility habits (number of cars in the family, bus use, cycling). The second part included questions related to sustainable mobility topics with 14 items. Data was collected between December 2022 and February 2023.

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OBJECTIVE: To compare differences in observed and self-reported team dynamics between those who received versus those who did not receive TeamSTEPPS training prior to an interprofessional escape room scenario. METHODS: Final-year pharmacy (N = 27) and physician assistant (N = 88) students participated in an escape room featuring pediatric dosing, asthma, otitis media, type 1 diabetes, and vaccine fundamentals. In total, 29 teams were randomized to control (14) or intervention arm (15). The control group went to the escape room and then returned to the classroom for a team-building module including TeamSTEPPS training. The intervention group started with the team-building module then went to the escape room. One faculty observer was assigned to each team and utilized the Performance Assessment Communication and Teamwork (PACT) expert-observer form to assess team performance. Post-event, students completed an abbreviated PACT post-assessment and a self-reflection on the prompt "What were the most important takeaways from today's interprofessional education experience?" RESULTS: On the PACT expert-observer form, significantly higher global scores were noted for the intervention arm on all items except situation monitoring. On the aggregate observer data from all stations, leadership emerged as statistically different between the 2 groups. On the PACT post-assessment, the intervention arm reported significantly more leadership during the simulation. On the self-reflections, 70.9% versus 64% in the control arm recognized the importance of teamwork in managing patients. CONCLUSIONS: Just-in-time TeamSTEPPS training improved observed and to a lesser extent, self-reported teamwork and communication skills. Incorporating TeamSTEPPS training immediately prior to an interprofessional education experience may enhance team performance.

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Excessive salt intake is a risk factor that leads to cardiovascular diseases. Public education on healthy eating habits and maintaining a healthy lifestyle can enable consumers to make better informed choices. This study developed a Metaverse Escape Room to increase public awareness on the "War Against Salt". Known as "The Saltomachy War" (TSW), 29 participants played the game in teams to solve puzzles across five "worlds" (rooms) to "escape" the game. Median post-game knowledge quiz scores were significantly higher than the pre-game quiz scores (12/15 versus 9/15, p<0.001). All players agreed that the content in TSW was useful in daily life (100%). TSW was easy to navigate (93.1%) and majority were engaged and actively participated in gameplay (96.6%). The storyline was creative and interesting (93.1%). Almost all players liked TSW to be in their curriculum and would recommend TSW to friends and family (96.6% each).

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