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THE GREAT ESCAPE�CREATING A SIMULATION ESCAPE ROOM�FOR YOUR STUDENTS

Liz Santamaria, BSRC, RRT

Stephanie Marcincavage, BS, RRT

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ABOUT THIS WORKSHOP

Participants will learn how simulation escape rooms can play an integral role in effectively creating ​a more engaging learning environment, all while improving learning outcomes and allowing students to develop 21st century skills.

Major components of an escape room will be discussed, along with considerations, limitations, and tips.

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OBJECTIVES

By the end of this presentation, participants will be able to:

DISCUSS

LIST

IDENTIFY

Discuss benefits to student learning from incorporating simulation escape rooms into a course.

List key principles of building a simulation escape room.

Identify challenges, limitations, and considerations of building a simulation escape room.

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DISCLAIMER

While the presenters specialize in the health sciences, the implementation of escape rooms can be done for a wide variety of subjects.

Healthcare, STEM, strategic communication, creative design, English, disaster preparedness, information literacy, workplace situations, and institutional learning outcomes can all be used to create the theme for your own simulation escape room.

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WHAT IS AN ESCAPE ROOM?

“A live-action team-based game where players discover clues, solves puzzles, and accomplish tasks in one or more rooms in order to accomplish a specific goal (usually escaping from the room) in a limited amount of time”

-Tarldsen et al., 2022

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Why might an escape room be a good fit for your learner?

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RELATION TO LEARNING

“21ST CENTURY” SKILLS

  • Highlights critical thinking, creativity, problem-solving, group dynamics
  • Socially proactive

EXPERIENTIAL LEARNING

  • Learning through observation and active participation
  • Gets out of rote-style/lecture-style/passive education and communication

GAME-BASED LEARNING

  • Intent is “fun” social interaction
  • Increases engagement
  • Appeals to different learning preferences

LEARNING THEORIES

  • Behaviorism
  • Constructivism
  • Socio-Cultural/Social Cognitive

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IMPROVING LEARNING OUTCOMES

AUTHENTIC, REAL-LIFE SCENARIOS

MOTIVATION, ENTHUSIASM, CURIOSITY

APPLYING CURRICULUM CONTENT

“21ST CENTURY” SKILLS

WORK QUICKLY, COMPETENTLY, & EFFICIENTLY AS A TEAM

MAKE THE EXPERIENCE OF A SUBJECT FUN, GENERATE CURIOSITY AND ENTHUSIASM IN DISCUSSION

CRITICAL THINKING, CREATIVITY, GROUP DYNAMICS, INITIATIVE, PROBLEM-SOLVING

APPLY PREVIOUSLY LEARNED KNOWLEDGE AND SKILLS IN A MORE COMPLEX WAY; FORMATIVE ASSESSMENT

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How do escape rooms engage the learner?

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LEARNER ENGAGEMENT DIRKSEN, 2016

URGENCY

COLLABORATION

“SHINY THINGS”

Students are more engaged when they sense immediacy and are presented with time constraints. Students want to focus on the “right now” with a compelling dilemma.

Students tend to perform better when interacting with peers. Group dynamics allow for students to support and serve as resources for each other.

Tactile activities can keep students focused. Physical interaction attracts attention by means of a different type of interaction with the content.

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PRINCIPLES OF �ESCAPE ROOMS �Laerdal (n.d.)

A STORY

Your SER should have an appropriate theme and narrative to encourage learners to take their roles seriously.

A DIFFICULTY LEVEL

Having an appropriate level of difficulty challenges learners in concepts they have already been introduced to. They should never be so difficult to prevent completion.

A REALISTIC ENVIRONMENT

Using a realistic environment reinforces desired skills, like communication, critical thinking and problem solving.

A PRE-BRIEF

An introduction to the event to explain rules, delegate roles, and introduce the scenario.

A TIME LIMIT

Depending on your learning objectives and puzzle layout, SERs usually are 15 to 60 minutes.

A DEBRIEF

Students benefit from reflection on their experience, explanation of their decisions and actions, and asking questions.

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MAIN COMPONENTS OF AN ESCAPE ROOM

  • Learning Objectives
  • Narrative
  • Blueprint
  • Debrief

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BUT FIRST…

Identify your theme. This will not only help create your learning objectives, but also your narrative later.

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LEARNING OBJECTIVES

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LEARNING OBJECTIVES

WHAT

The skills, behavior, or knowledge you expect your students to learn at the end of the simulation.

WHO

Identify your learners. What have they already been introduced to? What skill or knowledge level do they already have? (Harrington & Simon, 2021)

WHY

Creating your learning objectives will help in the construction and progression of your SER (Baily, 2021).

HOW

Determine if your objectives are related to assessment skills, care plans/protocols, soft skills, or physical skills (Baily, 2021).

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BE S.M.A.R.T

  • S-SPECIFIC
  • M-MEASURABLE
  • A-ATTAINABLE/ACHIEVABLE
  • R-RELEVANT
  • T-TIMELY

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BE S.M.A.R.T. HARRINGTON & SIMON, 2021

What do you need to achieve?

Who needs involvement to accomplish the goal?

When do you want to have your goal finished?

Why exactly should your students achieve this goal?

SPECIFIC

How can you measure progress and know if your students have successfully met the goal?

MEASURABLE

ATTAINABLE/ACHIEVABLE

Are your students capable of achieving the goal?

Do your students have the needed skills?

Can the learners meet the goals through simulation?

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BE S.M.A.R.T. HARRINGTON & SIMON, 2021

Why should your learners achieve this goal?

What is the impact?

RELEVANT

What is the timeline of your goal?

Can the learning objectives be met in the time allotted for the scenario?

TIMELY

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Bambini, 2016

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EXTRA TIPS

STRUCTURE

“The learner will…”

Continue with a verb, followed by an object.

Use Bloom’s taxonomy to select your verb: simulation is higher level ⇨apply, demonstrate, implement, perform, respond, identify, prioritize, manage, initiate (Bambini, 2016).

SKILLS

If clinical knowledge based, make a list of the skills students should demonstrate (Davis et al., 2021).

Effective teamwork and communication are inherent to SERs and real-world application, so it is appropriate to include team-based skills (Davis et al., 2021).

This Photo by Unknown Author is licensed under CC BY-NC

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BUILDING THE NARRATIVE

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THE NARRATIVE

STORYLINE

Provides a consistent, immersive narrative for the activity that is directly related to your clinical theme (Davis et al., 2021).

TEMPLATE

Use a template or storyboard to include: pre-brief introduction, phases and triggers… (Harrington & Simon, 2021)

LEARNING OBJECTIVES

Transition of activities keeps the students moving forward and focused on their learning objectives (Baily, 2021).

FLOW

The narrative should have distinctive phases: beginning, middle, and end (Bambini, 2016).

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FLOW BAMBINI, 2016

BEGINNING PHASE

Sets the scene, describes what the students find as they begin the scenario. Can include history of present illness, bedside report, and physical environment.

MIDDLE PHASE

Change in the beginning phase. Can include change in patient status, environment, or discovery of key piece of information.

ENDING PHASE

Requires a variety of actions that a learner performs and knowing how the situation would change based on those actions. Describes the ending scene.

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CONSIDERATIONS

IMPROVISED ACTIONS

Consider how alternate or improvised actions may affect the goal of the escape room and if students can properly recover from “wrong” actions.

ENDING

Like actions, having alternate endings could affect your goal.

You should have one end goal for your SER depending on how you want your students to “escape.”

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CREATING THE BLUEPRINT

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NARRATIVE VS. BLUEPRINT

In this presentation, the narrative is defined as the scenario or storyline that progresses through phases and actions.

The blueprint will be how the “escape room” element fits in. It incorporates clues, riddles, or puzzles that come with, follow, or precede the actions in the narrative that lead to the “escape.”

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CHOOSE A THEME

“ESCAPE” THEME

  • Narrative
  • Unlock all locks
  • Solve all puzzles

GOAL

  • Should have one escape goal.
  • As mentioned previously, having multiple ending possibilities could confuse your students.

DIFFICULTY

  • Make it easier than you think.
  • Don’t have unnecessary complexity or ambiguity (Davis et al., 2021).

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ADDITIONAL TIPS DAVIS ET AL., 2021

Incorporate the use of puzzles with a defined task.

If learners do something, they might find a clue.

Tasks should align with learning objectives.

Each puzzle should only be used once and then retired.

Participants should have to solve every puzzle to escape.

Easier to design tasks so that they cannot be completed out of order.

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TYPES OF PUZZLES

COMBINATION LOCKS

BLACKLIGHT & INK​

PADLOCKS

HIDDEN CODES​

RIDDLES

JIGSAW PUZZLE PIECES

ANAGRAMS​​

HIDDEN OBJECTS

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PUZZLES TO AVOID

TRIVIA

While tasks should relate to concepts that have already been introduced, trivia questions can easily confuse or disengage learners.

MULTIPLE SOLUTIONS

Again, tasks and puzzles should have one solution.

ARITHMETIC

Depending on overall context, math problems can be trivial and not related to the learning objectives.

FINICKY TECHNOLOGY

Learners should be able to solve puzzles when done properly. Technology that does not produce same results can frustrate learners.

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DEBRIEF

  • Debriefing allows students to reflect on their actions, review objectives, and further discuss the subject matter of the escape room.

  • It also serves as an evaluative tool for revision of future escape room events.

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LET’S PLAY

  • What’s your theme?
  • One learning objective?
  • Quick narrative?
  • Escape room element? (Think puzzle/clue)

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CONSIDERATIONS & LIMITATIONS

Focus is more on “short-term” results like motivation and enjoyment.

Need more longitudinal studies.

Research on outcomes is still preliminary

Group size, context, time, game master influence, rules…

Design

Running an escape room for students is intense.

Planning, development, revision

Ability to properly and adequately assess learners’ competence before, during, and after escape room needs to be considered.

Evaluation

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FINAL THOUGHTS

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REFERENCES

  • Baily, K. (2021, February 5). Clinical simulation escape room tips, tricks & hacks from IMSH 2021. HealthySimulation.com. https://www.healthysimulation.com/30309/clinical-simulation-escape-rooms/

  • Bambini, D. (2016). Writing a sample simulation scenario: A step-by-step guide. AACN Advanced Critical Care, 27(1), 62-70. https://doi.org/10.4037/aacnacc2016986

  • Brown, N., Darby, W., & Coronel, H. (2019). An escape room as a simulation teaching strategy. Clinical Simulation in Nursing, 30, 1-6. https://doi.org/10.1016/j.ecns.2019.02.002

  • Davis, K., Lo, H., Lichliter, R., Wallin, K., Elegores, G., Jacobson, S., & Doughty, C. (2021). Twelve tips for creating an escape room activity for medical education. Medical Teacher, 44(4), 366-371. https://doi-org.ezproxy.neu.edu/10.1080/0142159X.2021.1909715

  • Dirksen, J. (2016). Design for how people learn. (2nd ed.). New Riders.

  • Haman-Prewill, F. & Williams, T. (2020, December). Using an escape room to raise campus awareness of institutional student learning outcomes from NILOA. LearningOutcomesAssessment.org. https://www.learningoutcomesassessment.org/wp-content/uploads/2020/12/AiP-Chatt-state.pdf

  • Harrington, D.W. & Simon, L.V. (2021). Designing a simulation scenario. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK547670/?report=classic

  • Laerdal (n.d.). How simulation escape rooms can make learning stick. https://laerdal.com/us/

  • Novak, J., Lozos, J. C., & Spear, S. E. (2019). Development of an interactive escape room intervention to educate college students about earthquake preparedness. Natural Hazards Review, 20(1). http://dx.doi.org/10.1061/(ASCE)NH.1527-6996.0000322

  • Taraldsen, L. H., Haara, F. O., Lysne, M. S., Jensen, P. R., & Lenssen, E. S. (2022). A review on use of escape rooms in education- touching the void. Education Inquiry, 13(2), 169-184. https://doi.org/10.1080/20004508.2020.1860284

  • Waxman, K. T. (2010). The development of evidence-based clinical simulation scenarios: Guidelines for nurse educators. Journal of Nursing Education, 49(1), 29-35. https://doi.org/10.3928/01484834-20090916-07