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fjieowajPracticing Quality and Safety in Medication Administration:
Comparing High-fidelity Simulation to an Escape Room Experience to
Evaluate Student Knowledge, Self- Efficacy, & Critical Thinking
Elise Thompson RN, PhD Colette Waddill DNP, RN, IBCLC, CNE,
CHSE
114th Annual Convention Concord, NC | September 23-24, 2021
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• No conflicts of interest
• We do not endorse any type of product that may be listed in this
presentation
• The pilot study was funded by the UNCW SON Corbett Charitable
Trust
Learning Outcomes
1. Describe how to use escape rooms for medication
administration.
2. Compare and contrast the use of an escape room versus
traditional simulation.
3. Summarize benefits and challenges of using escape rooms in
nursing education.
Polling Time!
Table Discussion
1. If you have used escape rooms, how have you used them?
2. If you have not used escape rooms, how do you envision using
escape rooms in nursing education?
Discuss for 1-2 minutes. Large Group Discussion
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• What professions?
• What are some of the benefits of escape rooms?
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• Student Perceptions – Preparedness for Med Admin – Performance
for Med Admin
• Critical Thinking – Mixed Reviews in literature
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Learning Activity Comparison
High Fidelity Simulation
• Strategy to teach a wide variety of topics and can closely mimic
the clinical environment.
• Students implement patient care interventions based on patient
presentation.
Escape Room
• Solve puzzles and find clues in order to move to the next
task.
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• What has already been done?
• How do escape rooms work?
• Equipment
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• Needs Assessment • Measurable Objectives • Simulation Format •
Case to Provide Context • Fidelity • Facilitative Approach •
Preparation Materials • Pre-brief • De-brief • Evaluation • Pilot
Test
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Scenario • The patient scenario should be based on course content
and
objectives of the learning activity. • The scenario is important to
provide relevance and realism to
the learning activity. • To care for their patient, they need a
backstory and report
about what is going on with the patient now. • They also need to
understand the goal of the learning activity
and how they will be able to progress through the scenario. •
“There’s a locked box in the room. Your mission is to
complete
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Equipment • iPad • 2 Large Boxes • 2 Small Boxes • 4 Different
Locks • Laminator • Velcro • Whiteboard Markers • Manikin:
settings, script • Armbands, stethoscope, BP cuff,
thermometer,
O2 sat monitor, urine specimen
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• Openness breeds creativity
®
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Arts & Crafts
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• Include scenario
• Pre-work • Pre-brief • Scenario • De-brief
• Be prepared to adapt – COVID restrictions – Time elements
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Results
Age Mean/ Range 20.29/ 19-22 Gender All Female Culture White: 22;
Hispanic: 2
Previous ER Experience 23/24 Previous HFS Experience 21/24 Previous
Healthcare Experience
11/24
Results Knowledge ER n=5 Post M=41.2 SD=7.190
> Pre M=36.6 SD=8.849 Knowledge HFS n=8 Post M=34
SD=14.323
< Pre M=37.88 SD=8.999 Self Efficacy ER n=5 Post M=52.8
SD=2.588
> Pre M=49.2 SD=3.421 Self Efficacy HFS n=8 Post M=50.13
SD=6.917
> Pre M=47.5 SD=5.855 Critical Thinking ER n=3 Post M=79
SD=11.79
> Pre M=78 SD=6.245 Critical Thinking HFS n=8 Post M=75.38
SD=8.052
= Pre M=75.38 SD=6.968
Paired t-test Results
*ER: Improvement shown in knowledge, self-efficacy, and critical
thinking.
*HFS: Improvement shown in se lf-efficacy, no change in critical
thinking, decline in knowledge.
*ER participants had higher scores for all pre - and post- tests
except knowledge pre -tests upon comparison of groups.
*not statistically significant due to sample size
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Pilot Study What did we learn? • Students reported enjoying both
experiences
• Students reported learning from both experiences
• Initial results suggest ERs may provide equal or
better outcomes than HFS
completion rates
Pilot Study
What do we still want to know? • Is there a difference in ER or HFS
experience for
knowledge, self-efficacy, and critical thinking related to safe
medication administration?
• Are findings generalizable? – Possible multi-site study (increase
diversity) – Include BSN and ADN students
• Are findings statistically significant? – Increase number of
completed surveys
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Benefits of Escape Room Experience • Can be used for a variety of
learning needs
• Structured process guides students through recognizing and
interpreting patient cues
• Best for novice or new to learning skill/concept
• Combine with simulation or other learning strategies
• Promotes teamwork and collaboration
critical thinking
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Challenges of Escape Room Experience • Additional time to develop •
Requires supplemental equipment
– Set-up and breakdown time – Training students on use – Cost of
purchase, maintenance, replacement
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– Learning skills – Practicing patient care – Reinforcing classroom
concepts
• Incorporates visual, verbal, kinesthetic, logical, and social
learning styles
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Kimhi, E., Reishtein, J. L., Cohen, M., Friger, M., Hurvitz, N.,
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References Miller, S. (2015). The art of the escape room. Newsweek.
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Disclosures
High Fidelity Simulation
Learning Activity Comparison
Escape Room Design: Best Practices
Scenario
Equipment
Brainstorming
Collaboration
Implications for Nursing Education