An escape room simulation focused on renal-impairment for prelicensure nursing students

The effects of flipped learning and gamification on nursing students' patient safety education: A mixed method study

Background

The importance of enhancing education to promote nursing students' patient safety competency is increasing. Hence, implementing diverse educational programs and assessing their outcomes is essential.

Objectives

To examine the effects of flipped learning and gamification on nursing students' patient safety education.

Design

A mixed-method design employing a quasi-experimental design with a pre-post control group design and qualitative thematic analysis.

Methods

The study was conducted at a South Korean university in W City from September to December 2022. It included 55 s-year nursing students. The experimental group (n = 28) participated in a 30-h patient safety education course using flipped learning and gamification, whereas the control group (n = 27) received only written patient safety education materials. Learning motivation, collective efficacy, patient safety competency, and game evaluations were measured. Data were analyzed using the χ2 test, Fisher's exact test, t-test, repeated-measures multivariate analysis of covariance, repeated measure analysis of covariance, and generalized estimating equations. Self-reflection journals on game participation experiences were analyzed using qualitative thematic analysis.

Results

Learning motivation scores did not differ significantly between groups for time, or interactions between groups and time, but collective efficacy and patient safety competency scores showed significant differences in the interactions between groups and time. The experimental group showed a high satisfaction score in game evaluation. Qualitative analyses were used to extract four themes-three positives: "fun and immersion differentiated from existing classes," "improved the learning outcomes and learning motivation," and "realized the value of collaboration and communication," and one negative: "feeling down due to unfamiliarity."

Conclusions

This program creates positive learning experiences and enhances nursing students' collective efficacy and patient-safety competencies. It is expected to be utilized in various future nursing courses.

Simulation-based learning in nephrology

Simulation is a technique to replace and amplify real experiences with guided ones that evoke or replicate substantial aspects of the real world in a fully interactive fashion. In nephrology (a particularly complex specialty), simulation can be used by patients, nurses, residents, and attending physicians alike. It allows one to learn techniques outside the stressful environment of care such as central venous catheter placement, arteriovenous fistula management, learning about peritoneal dialysis, or performing a kidney biopsy. Serious games and virtual reality are emerging methods that show promise. Simulation could also be important in relational aspects of working in a team or with the patient. The development of simulation as a teaching tool in nephrology allows for maintaining high-quality training for residents, tailored to their future practice, and minimizing risks for patients. Additionally, this education helps nephrologists maintain mastery of technical procedures, making the specialty attractive to younger generations. Unfortunately, the inclusion of simulation training programmes faces occasional logistical or funding limitations that universities must overcome with the assistance and innovation of teaching nephrologists. The impact of simulation-based teaching on clinical outcomes needs to be investigated in clinical studies.

Advanced clinicians' experience of participation in an escape room scenario designed to consolidate crisis resource management principles: An exploratory pilot study

BACKGROUND

Intensive care outreach nurses are required to work as part of an ad hoc team to review and manage patients who are deteriorating outside of critical care environments. Nontechnical skills, such as those encompassed by crisis resource management principles, are essential when working in these situations. Used commercially for entertainment, escape rooms have recently been utilised by clinical educators to teach both technical and nontechnical skills.

OBJECTIVE

This exploratory study evaluates how advanced clinicians, intensive care outreach nurses, experience an escape room scenario designed to consolidate crisis resource management (CRM) principles.

METHODS

Three escape room sessions were conducted in a 1038-bed metropolitan tertiary referral hospital. A purposive sample of 12 intensive care outreach nurses were invited to participate. The participant's experience of the escape room scenario was determined by their responses to a post-escape room survey and focus group discussion. Transcripts of the audio recordings from focus group discussions were analysed using an inductive coding approach.

RESULTS

Two primary categories emerged from analysis of the focus group discussions: (i) the clinicians' experiences of the escape room and (ii) CRM principles. The first category included descriptions of emotions, including confusion, frustration, and a dislike for puzzles. The second category included both the participants understanding of the CRM principles, and how the principles influence the work within the escape room.

CONCLUSIONS

Escape rooms have shown promise as novel educational environments, which challenge participants. Despite initial negative descriptions of the escape room, focus group discussions demonstrated that the participants were able to recognise the impact of CRM principles and acknowledge how these affect their clinical work in an ad hoc team.

Educational escape rooms for healthcare students: A systematic review

OBJECTIVES

To synthesize evidence on the implementation and evaluation of educational escape rooms for healthcare students.

DESIGN

A systematic review.

DATA SOURCES

A search of seven databases including PubMed, Scopus, Web of Science, Cochrane, EMBASE, CINAHL, and Education Resources Information Center was conducted for published studies from inception to January 2023. The selected articles were assessed by two independent researchers for meeting the inclusion criteria and methodological quality. The data was narratively synthesised.

RESULTS

Fifty-two studies were included in the review. Escape rooms were employed as learning and assessment strategies for the delivery of diverse topics within dentistry, medical, nursing, pharmacy and physiotherapy pre-registration healthcare education. Most were conducted on nursing students with learning topics focusing on the development of knowledge related to patient care management. Virtual escape rooms became more prevalent following the COVID-19 pandemic. The specific design features of escape rooms were based on the elements of game-based learning including team learning with appropriate size, time limit and sequential path-design of puzzles. Applying the experiential learning approach, the facilitators played a pivotal role in pre-briefing, facilitating the gameplay, and debriefing. Escape rooms were evaluated to be enjoyable and have an impact on students' cognitive, psychomotor, non-technical and affective skills learning outcomes. However, the learning outcomes compared with conventional learning strategies were inconclusive due to lack of randomised controlled trials.

CONCLUSION

Escape rooms are increasingly being used as experiential and game-based learning in healthcare education. It will continue to evolve with virtual technology advancement and is a promising tool to provide virtual team training within interprofessional education for the development of teamwork and communication skills. While more rigorous research using a randomised controlled trial design is needed to evaluate the effectiveness of escape rooms and their design features, qualitative studies, particularly on the perspective of facilitators are needed to unravel the learning process.

Escape rooms in nursing education: An integrative review of their use, outcomes, and barriers to implementation

OBJECTIVES

Escape rooms are becoming a popular teaching method in a variety of fields and settings, but have not been examined for their effectiveness in nursing education. The aim of this integrative review was to map trends in escape rooms in nursing research and evaluate support for using this innovative, simulation-based teaching method.

DESIGN, DATA SOURCES, AND REVIEW METHODS

Using Whittemore and Kanfl's framework, this integrative review analyzed the use of simulation-based escape rooms in nursing and nursing education. Results were refined using inclusion and exclusion criteria, and evaluated with use of the Mixed Methods Appraisal Tool. Databases searched were PubMed, CINAHL, PsychINFO, Google Scholar, and ERIC.

RESULTS

A total of 18 studies were included. Common categories identified included student satisfaction with escape rooms and barriers of cost and time to educators. Desired outcomes of the studies reviewed focused on teamwork, perceived learning or increased confidence, or increase in knowledge. Optimal group size and theoretical support recommendations for escape rooms are lacking with the need for further research.

CONCLUSIONS

Escape rooms are effective at improving knowledge in a variety of nursing education topics, and their use has been well-received in a variety of nursing and professional health students. Long-term outcomes have not been assessed. There is need for more research in assessing ideal group size when using escape rooms in education settings, more rigorous study design to determine effectiveness of escape rooms to produce education-focused outcomes, and more consensus on appropriate theoretical frameworks that can guide the implementation and study of escape rooms in practice.

Innovative Teaching Strategies Using Simulation for Pediatric Nursing Clinical Education During the Pandemic: A Case Study

Existing challenges associated with pediatric clinical placements for prelicensure nursing students were heightened when clinical agencies halted nursing student entry in response to the COVID-19 pandemic. At the same time, the pandemic created opportunities for innovative teaching strategies for pediatric clinical rotations in nursing education. The purpose of this project was to design, develop, and implement meaningful, interactive, and intentional clinical experiences for nursing students that enhanced their pediatric assessment skills, reduced their anxiety about pediatric inpatient care, and advanced their proficiency in the nursing process. Two simulated clinical experiences were created: (1) a virtual pediatric physical assessment checkoff and (2) a pediatric escape room. The pediatric physical assessment checkoff was performed in a remote, virtual setting while students used personal resources to demonstrate their assessment skills. For the escape room, students worked in small, in-person groups using the nursing process to unlock clues to improve their client's health condition. Students reported gaining meaningful clinical experiences through simulation that allowed them to apply their nursing knowledge and increased their confidence in pediatric assessment skills, dosage calculation competency, communications and interactions with the pediatric population, and teamwork abilities. The virtual pediatric physical assessment checkoff and the pediatric escape room were enjoyable and beneficial educational events that facilitated student learning.

Digital Escape Rooms as Innovative Pedagogical Tools in Education: A Systematic Literature Review

This paper aims to present a systematic literature review on state-of-the-art Educational Escape Rooms (EERs) with the use of digital technologies. More specifically, the focus of the study is to present the current developments and trends concerning Digital Educational Escape Rooms (DEERs) and investigate how they foster learning outcomes for online learners. Additionally, the present study provides insights into the design process of such technology enhanced EERs. This review is attributed to identifying and covering research gaps since the current literature has focused on the pedagogical aspects of Escape Rooms (ERs) in education, but no studies seem to have been conducted in regard to the pedagogical implications of Digital Escape Rooms (DERs) in educational environments. Based on the exhaustive literature review, an agenda for future research is promised and the implications for designing innovative ER approaches have been highlighted. The anatomy of the fundamental components of conducting systematic literature reviews was followed. The results of the review could be addressed to multidisciplinary teams related to education, game researchers, educational researchers, faculty members, scholars, instructors, and protagonists of educational systems to encourage them to thoroughly study the core elements of DEERs and how they can be applied in virtual educational contexts to facilitate students’ learning achievements.