As nursing professional development (NPD) practitioners, we are presented with the challenge of educating nurses of varying experience levels simultaneously. Using a variety of educational methods gives us flexibility when engaging a larger audience. The lecture method could potentially become monotonous, and therefore may lack engagement as student learning styles vary.

To maximize participants’ learning potential, we created “Mission Possible: Medical/Surgical Escape Room Challenge,” a blended learning course designed to engage learners using different teaching modalities. While educating nurses, it is important to assess their individual learning needs and formulate a learning modality based on the knowledge gap. Learners' comfort with various teaching modalities can be daunting for educators — “a challenge recognized by educators is student’s comfort with different teaching methodologies” (Woodworth 2020). “Mission Possible: Medical/Surgical Escape Room Challenge” is an annual education requirement for medical-surgical nurses offered twice a month at our organization. The course covers mandatory topics and education on existing and/or new equipment or practices. Based upon earlier evaluations of annual education course offerings, it became clear that our previous lecture-based modality needed to improve to be more effective in engaging the learners. This was validated by evaluations reflecting 94% agreement with this modality of learning.

Northwell Health encourages a safe, educational learning environment, so it was important to incorporate the system’s core values in the building of our education model. The nurse educators created a plan to have the learners immersed in a fully interactive experience, one in which they needed to build on information they already knew and work as a team to solve a problem. This is how “Mission Possible: Medical/Surgical Escape Room Challenge” was born.

The topics covered in this course were chosen based on Staten Island University Hospital’s quality indicators and with performance improvement initiatives in mind. Learners navigate through the escape room and must solve problems related to skin integrity, catheter-associated urinary tract infections, heparin nomogram, restraints, and more. Topics can be updated annually based on learner needs and changes to nursing practice.

“Mission Possible: Medical/Surgical Escape Room Challenge” uses clues that require participants to work as a team to move sequentially through each learning activity. This forced interdependence also allows members to work on team building and knowledge sharing to solve problems. The team members have a shared goal to escape the escape room in record time while providing safe and efficient care to the patient. Innovative techniques were utilized, such as QR codes, YouTube sound bites, and Vocaroo voice recordings. Each escape room session is timed, and each team competes for the best time. Classes are capped at ten participants. We have ascertained that ten people or less is optimal for this modality. Thus, one class is one team. We try to engage all learners by brief introduction in the beginning of class, and then request volunteers for different roles. For example, one station has learners assess if the foley is appropriate: To remove or not to remove—that is the question! The learners use critical thinking to determine that the foley is not necessary for this patient. Foley removal is simulated on a mannequin. Once removed they find a code on the catheter, which must be decoded to proceed to the next clue.

Setup and takedown of the escape room takes around 15 minutes. An escape room challenge has been successful in this facility as the feedback has been overwhelmingly positive. Upon completion of each escape room challenge, the learners are asked to complete an anonymous course evaluation. Although this method of teaching has proven effective and engaging, we continue to offer traditional classes. Over nine months, 94% of learners have indicated that they prefer the escape room learning method as compared to 6% of learners who prefer the traditional methods of classroom instruction. Post-escape room evaluations have shown 98% of participants stated that this teaching modality has been widely effective in increasing knowledge and enhancing the participant’s fervor for learning.

References

Escape education: A systematic review on escape rooms in education. (2020). Educational Research Review, 31, 100364. https://doi.org/10.1016/j.edurev.2020.100364

Woodworth, J. A. (2020). Escape Room Teaching Pedagogy in the Didactic Learning Environment for Nursing. Nurse Educator, Publish Ahead of Print. https://doi.org/10.1097/nne.0000000000000847