Effect of an escape room as a gamification evaluation tool on clinical reasoning and teamwork skills among nursing students: A quasi-experimental study

Nurse Educ Pract. 2025 Jan:82:104188. doi: 10.1016/j.nepr.2024.104188. Epub 2024 Nov 14.

Abstract

Aim: This study investigates the impact of using escape rooms as a gamification evaluation tool on nursing students' clinical reasoning and teamwork skills.

Background: Escape rooms, originating in Japan in 2007, are team-based live-action games requiring participants to solve puzzles within a time limit. They develop essential skills such as teamwork, leadership, logic, creativity, critical thinking, communication and problem-solving. Educational escape rooms' focuses on learning goals connected to curricula and are tailored to specific student groups.

Design: Pretest and posttest quasi-experimental study with a study and control groups were conducted.

Methods: The study involved 160 fourth-year nursing students, divided into study (80) and control (80) groups over four months, from October 2023 to the end of January 2024, in Egyptian, Alexandria nursing college. The tools used included the Teamwork Skills Questionnaire, the Nurses Clinical Reasoning Scale and a socio-demographic and academic data questionnaire.

Results: The study group showed significant improvements in clinical reasoning and teamwork skills post-intervention. Positive correlations between clinical reasoning and teamwork skills indicated that the escape room experience has a significant impact on students' critical thinking and collaborative abilities.

Conclusion: Escape rooms are effective educational tools for enhancing nursing students' clinical reasoning and teamwork skills, bridging the gap between theoretical knowledge and practical application. Escape rooms can be valuable additions to traditional teaching methods, better preparing students for clinical practice.

Keywords: Clinical reasoning; Escape room gamification; Evaluation; Nursing students; Quiz-experimental study; Teamwork skills.

MeSH terms

  • Adult
  • Clinical Competence
  • Clinical Reasoning
  • Cooperative Behavior
  • Curriculum
  • Education, Nursing, Baccalaureate*
  • Egypt
  • Female
  • Humans
  • Male
  • Problem Solving
  • Students, Nursing* / psychology
  • Surveys and Questionnaires
  • Thinking
  • Young Adult