Escape Rooms Make Competencies Fun and Engaging

Escape rooms offer a competitive, interactive and immersive gaming experience. In this blog, Andrea Heimer, a clinical nurse educator, shares with Michelle Sanchez, MSN, RN, CPHQ, AACN Beacon program manager, how she employed an escape room strategy to create an educational experience for competency assessment.

How was your last competency validation experience?

We had the BEST time on our last competency assessment day. I never thought I would say those words, but it’s true! The staff had fun, and we were completely engaged. Who says fun and competency day go together? We do, because we gamified competency day with an escape room.

Why did you think an escape room was right for your unit?

After attending webinars and participating in journal clubs related to gaming in nursing and the use of escape rooms to promote staff engagement, improve critical thinking and test knowledge, I thought this would be a fantastic concept to beat the competency day blues.

Where did your team start?

The first thing was the literature search. We found no literature on the use of escape rooms in critical care, but plenty on nurse residency, new graduate programs and other healthcare areas. These were a great starting point, but we also went outside of healthcare and used ideas from education and escape room sites.

What steps did you take to plan, build and execute your escape room?

• 1We attended an escape room as a team, which helped us understand how they function and to get ideas for puzzles and clues.

• 2We chose identification and treatment of severe sepsis deteriorating to septic shock, using current CMS requirements and outcome measures. It was a challenge to create a scenario robust enough to cover all learner levels, and promote critical thinking and collaboration. The team approach we used supports shared learning and is helpful in unlocking the next clue.

• 3Next, the competency statement, learning objectives and overall goals of the escape room were developed. Puzzles and clues were created to move the staff through each scenario. We thought outside the nursing box for ideas, and teacher resource websites were especially helpful.

• 4The room was tested by the education team to ensure clues made sense and were revised accordingly.

• 5Then came the big reveal: 64 staff members attended in groups of four to six, and they LOVED it! Timing the teams adds to the competitive atmosphere. We highly recommend providing a fun certificate or other reward for completion as a form of recognition.

• 6A debrief with team members can ensure the right competencies were validated and reinforce the learning points from the escape room activities.

Prior to starting, staff completed a pretest for the knowledge and skills that were going to be validated while taking part in the escape room.

The Value of the Escape Room Experience

By escaping, all learning objectives were met. We measured nurse satisfaction using an escape room to assess competency and the percent that completed the escape room. Observations and evaluations revealed staff were more engaged than ever and requested an escape room experience for next year. Word has spread in our facility, and we’ve been asked to help other unit educators with planning and executing their escape rooms for competency validation.

What tips for success would you share with others?

• 1Attend an escape room! It’s fun and you can gather ideas.

• 2Have clear learning objectives and choose one of two scenarios:

  • Clues found in any order to meet the final objective
  • Clues experienced in a predetermined order where one clue leads to the next clue to meet the final objective

• 3Determine your plan and budget. Use different puzzles, games and tasks to achieve your objectives. Try blank puzzles from a craft store and write clues on them, and adapt board games; use a cipher or cryptic.

• 4All puzzles/clues can have only one solution, so there is nothing left open to interpretation. We used lab values, drug calculations and alphabet substitution codes for numbers and word locks.

• 5Test and retest! Test your escape room, and make sure you are meeting your objectives. If you make changes, test the room again to ensure the changes make sense.

• 6Always have a backup plan. A lock was accidently reset during use, and security needed to open it with bolt cutters - now we have extra locks just in case!

Resources to Help You Plan

• “Will You Escape?: Validating Practice While Fostering Engagement Through an Escape Room,” p. 271-276.
• “Behind the Scenes of an Educational Escape Room,” p. 50-56.

Practical application of solving puzzles to achieve a patient-focused objective can enhance team collaboration, engagement and confidence when facing this scenario while providing care. The possibilities to use escape rooms for competency validation are endless. We recommend the “Simulation Escape Room Workbook” to help you plan your adventure. Happy solving!

How could you use an escape room to engage your staff in learning or competency assessment?