Escape Room in Nursing education

Escape rooms are excellent learning activities in the training of health professionals, both postgraduate and undergraduate. Álvaro Trampal Ramos, aka @enfermerodesimulacion, tells us about it

Escape room activities or escapism rooms have been booming in recent years in the training of health professionals, both postgraduate and undergraduate. In this article we will analyze the basic elements that we must take into account when developing this gamification activity.

In the escape room, the students are “locked” in a room with the teacher and through tasks, riddles and solving a series of problems related to the objective of the activity, they have to get out of the room in a set time. Escape room activities are an excellent gamification tool in which we can achieve new learning or consolidate existing knowledge.

Like all activities based on clinical simulation, the escape room must be well planned. We can follow the standards set by the International Nursing Association for Clinical Simulation and Learning (INACSL) to design the activity, such as planning results and objectives, facilitation, prebriefing and structured debriefing, evaluation, etc.
A key point in this type of activity is the materials. We have all the imaginable materials at our disposal. The main materials that are usually used are:

• Padlocks: in the market we have a great variety of padlocks. They can be of numerical combination, with keys, of movement and featuring a multitude of shapes, colors and designs. They are an excellent tool for deciphering numbers and combinations. For example, we can mark drug doses, electrode position, movement of an electrocardiogram tracing in a lead as the key to open the padlock, and much more.
• Boxes: one of the most used tools in escape rooms are boxes. We have countless types and models. The participants in the activity will be under a lot of stress, so these boxes have to be resistant, since, in a hurry, the students may not be too careful with the material. Depending on whether we want the content of the boxes to be seen or not, we will have to buy or make opaque boxes. We can also add some opening or closing mechanism with a padlock, if it is not included in the box, as well as a hinge system.
• Another important item is a watch. Students must have a clear idea about the time they have to complete the activity. For this reason, we must use a clock in the scenario; it may be that of a computer or a stopwatch of the critical room.
• We can incorporate into our activity all the material that we can imagine; from a deck of cards, an invisible ultraviolet light pen, photos, to a high-tech manikin. All the activities that students carry out need to have a purpose, that is, a learning objective. For example, we can put a photo of Florence Nightingale with a question mark in the year of birth. Students will have to put 1820 on the lock in order to open it and discover the next clue. With this simple activity, we are making the student remember the year Florence Nightingale was born.

Another important point of the activity that we do not have to forget is space and time. It is not the same to perform an activity with a group a day, than with several consecutive groups. The ideal would be to have several identical rooms to be used in rotation. While we use one, a collaborator sets up another room again for the next group. I know this is not feasible most of the time, so we have to schedule the time that allows us to put the scenario back up for the next group. One solution is to carry out the debriefing in a separate room and have a collaborator prepare the scenario. To achieve an exact reproduction of the content of the room, it is recommended to take photographs of the space and the key points of the activity so that all the groups have the same experience.

When working with different groups it is important to stress the principle of confidentiality during the prebriefing; students do not have to reveal the “tricks” of the scenario to their classmates so that the new groups live the learning experience to the fullest.

Regarding time, it is an important factor: for this reason, it is advisable to carry out a previous piloting. Escape room activities usually last about 30 minutes, including a couple of lifeguards to help students continue if they get stuck. These lifeguards may be scheduled 10 and/or 20 minutes after the start of the activity; this time will vary depending on the complexity of the task and the objectives previously set.

In conclusion, gamification activities in health sciences are becoming more important every day, allowing students and teachers to escape the traditional model of lectures in which students are passive actors in the training. Escape rooms are excellent learning activities, allowing participants to acquire new knowledge or review what they have learned in a fun and enjoyable way.

Would you like to know more? Find more information in the Instagram video of @enfermerodesimulacion (Spanish language):

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