Engaging Students with Patient Safety in an Online Escape Room

Development and Implementation of a Safety Incident Report System for Health Care Discipline Students During Clinical Internships: Observational Study

BACKGROUND

Patient safety is a fundamental aspect of health care practice across global health systems. Safe practices, which include incident reporting systems, have proven valuable in preventing the recurrence of safety incidents. However, the accessibility of this tool for health care discipline students is not consistent, limiting their acquisition of competencies. In addition, there is no tools to familiarize students with analyzing safety incidents. Gamification has emerged as an effective strategy in health care education.

OBJECTIVE

This study aims to develop an incident reporting system tailored to the specific needs of health care discipline students, named Safety Incident Report System for Students. Secondary objectives included studying the performance of different groups of students in the use of the platform and training them on the correct procedures for reporting.

METHODS

This was an observational study carried out in 3 phases. Phase 1 consisted of the development of the web-based platform and the incident registration form. For this purpose, systems already developed and in use in Spain were taken as a basis. During phase 2, a total of 223 students in medicine and nursing with clinical internships from universities in Argentina, Brazil, Colombia, Ecuador, and Spain received an introductory seminar and were given access to the platform. Phase 3 ran in parallel and involved evaluation and feedback of the reports received as well as the opportunity to submit the students' opinion on the process. Descriptive statistics were obtained to gain information about the incidents, and mean comparisons by groups were performed to analyze the scores obtained.

RESULTS

The final form was divided into 9 sections and consisted of 48 questions that allowed for introducing data about the incident, its causes, and proposals for an improvement plan. The platform included a personal dashboard displaying submitted reports, average scores, progression, and score rankings. A total of 105 students participated, submitting 147 reports. Incidents were mainly reported in the hospital setting, with complications of care (87/346, 25.1%) and effects of medication or medical products (82/346, 23.7%) being predominant. The most repeated causes were related confusion, oversight, or distractions (49/147, 33.3%) and absence of process verification (44/147, 29.9%). Statistically significant differences were observed between the mean final scores received by country (P<.001) and sex (P=.006) but not by studies (P=.47). Overall, participants rated the experience of using the Safety Incident Report System for Students positively.

CONCLUSIONS

This study presents an initial adaptation of reporting systems to suit the needs of students, introducing a guided and inspiring framework that has garnered positive acceptance among students. Through this endeavor, a pathway toward a safety culture within the faculty is established. A long-term follow-up would be desirable to check the real benefits of using the tool during education.

TRIAL REGISTRATION

Trial Registration: ClinicalTrials.gov NCT05350345; https://clinicaltrials.gov/study/NCT05350345.

The effectiveness of the Escape Room as an educational methodology in the Infarction Code

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.

Facilitating undergraduate students' problem-solving and critical thinking competence via online escape room learning

AIMS

This study aimed to identify the efficiency of escape room activities in terms of enhancing nursing students' retention of maternity-related knowledge and their overall learning performance.

BACKGROUND

Novel teaching methods have been explored as alternatives to traditional approaches. One such strategy is the implementation of escape-room-based techniques, which have been used as an inventive educational approach in nursing. However, there is limited information available on specific applications, such as in maternity education.

DESIGN

The study conducted a quasi-experimental design during two semesters of an academic year (i.e., the 2021-2022 academic year). The study was conducted at a university, with participants enrolled in a maternity course.

METHODS

The experimental group engaged in an online game-based escape room learning activity during the pregnancy assessment session of their maternity course, while the control group learned with a traditional teaching approach. The Mann-Whitney U test was used to compare the performances of the two groups.

RESULTS

Findings from the experimental group suggested that incorporating an online game-based escape room approach into the learning process enhanced students' learning performance, problem-solving skills and critical thinking skills. Additionally, students expressed a consensus that learning through the online game-based escape room approach added enjoyment to the learning experience.

CONCLUSIONS

Maternity escape rooms" emerged as an online game-based approach that effectively stimulated nursing students and can serve as a practical resource for engaging in maternity care learning.

Virtual escape room paired with simulation improves health professions students' readiness to function in interprofessional teams

BACKGROUND

This project investigated the change in nursing, pharmacy, and physical therapy students' interprofessional socialization after participation in a virtual interprofessional escape room and case conference simulation.

INTERPROFESSIONAL EDUCATION ACTIVITY

Interprofessional teams of nursing (n = 93), pharmacy (n = 75) and physical therapy (n = 33) students completed asynchronous, online learning (sepsis recognition and total hip replacement post-operative precautions) followed by a virtual escape room and a virtual simulated patient case conference. During the case conference, interprofessional student teams developed a discharge plan for an individual after a hip replacement complicated by post-operative sepsis. Before and after the experience, students completed a knowledge test and a validated survey instrument that assessed their interprofessional socialization (Interprofessional Socialization and Valuing Scale-21). During the simulated patient case conference, faculty assessed student performance using a standardized rubric. After the experience students completed a program evaluation.

DISCUSSION

Interprofessional socialization significantly increased (5.5 ± 0.9 vs. 6.0 ± 0.9) among all students with a medium effect size (Cohen's d = 0.56). Faculty assessment of individual student's team performance during the virtual simulation revealed a moderate rate meeting competency, with good interrater reliability. Students highly valued this learning experience as being both effective and important to their professional development, as indicated on the program evaluation.

IMPLICATIONS

A virtual interprofessional experience consisting of asynchronous online learning, a virtual escape room, and a virtual case conference positively influenced students' interprofessional socialization. Students valued the experience and recognized its importance in their development as student health professionals.

An evaluation of undergraduate student nurses' gameful experience whilst playing a digital escape room as part of a FIRST year module: A cross-sectional study

BACKGROUND

The circumstances arising from the COVID-19 pandemic have accelerated the use of digital teaching and learning in health professions education. Digital gamification-based teaching and learning activities are innovative and versatile tools for the acquisition of professional competencies in higher education, which can be used on a range of topics and can be supplemental to other teaching methods.

OBJECTIVES

This study aimed to investigate nursing students' gameful experience whilst playing a digital escape room. In addition, we aimed to analyze the students' motivation, learning experience and outcome of the activity, and the students' perception of the degree of achievement of the intended learning outcomes.

DESIGN

Cross-sectional descriptive study.

PARTICIPANTS

A total of 136 undergraduate first year student nurses enrolled in a "Fundamentals of Nursing" course.

METHOD

The digital escape room game took place online during the academic year 2020-2021. The measures included the GAMEX scale in its Spanish version and a self-reported questionnaire to evaluate the outcome of the scape room game and the degree of achievement of the intended learning outcomes.

RESULTS

More than 80 % of the participants were moderately to very motivated to play the game. Three GAMEX dimensions achieved a mean score of 3 or above 3, namely Enjoyment, Creative Thinking and Absence of Negative effects. The mean score for each of the outcome variables was over 3. However, the degree of achievement of the learning outcomes after exiting the digital escape room was uneven.

CONCLUSION

Gamification-based teaching and learning activities, such as digital escape rooms, can be effective in fostering specific skills, including teamwork, communication and critical thinking. However, they should be designed carefully, and used as a complement, rather than a substitute, of other educational activities.