There is no I in Escape: Using an Escape Room Simulation to Enhance Teamwork and Medication Safety Behaviors in Nursing Students

Background. Nurse educators are challenged to develop simulation activities that will engage interest and help baccalaureate nursing students administer medications safely. Students must be able to recognize and report medication errors and effectively collaborate with their patient care team to provide safe and competent care to patients across the healthcare spectrum. Escape rooms are an innovative learning platform where students can work as a team to build these skills. Aim. We report on the strategies and resources used to create and implement an escape room simulation for a problem-based learning activity to practice medication safety behaviors, using critical thinking, communication and team building skills. Methods. Using Kolb’s Learning Cycle and the International Association for Clinical Simulation in Learning (INACSL) Standards of Best PracticeSM, we developed a team-based, four-hour escape room simulation activity around detecting and reporting medication errors in the hospital setting. The escape room simulation included a high-fidelity patient manikin, two embedded participants in the roles of family member and health care provider (HCP), puzzles, riddles, clues and lifelines. The learning objectives were paired with essential Quality and Safety Education for Nurses (QSEN) competencies. Promoting Excellence and Reflective Learning in Simulation (PEARLS) was used for debriefing. Results. The result was a hybrid escape room simulation that mimics a situation nursing students might face in the hospital setting where they have to work as a team to assess a new patient, reconcile medications, perform medication calculations, problem solve intravenous infusion set ups, and communicate medication errors. Data collected for quality purposes indicated a positive student response. Discussion / Conclusion / Implication. The escape room platform served as a foundation for incorporating other simulation modalities and provided a stimulating learning activity. The next step is to conduct a multi-site study with pre-test and post-test data collected from students to gauge learning and behavior change.