Escape Rooms: A Novel Strategy Whose Time has Come

Teaching strategies are developing rapidly to engage learners in the virtual and physical environment. The terminology used to fuse educators, researchers and students within a common paradigm and language is also evolving. This special edition of Simulation & Gaming seeks to guide simulationist in the use of innovative escape rooms and create unifying processes to report on this teaching strategy. This symposium of articles provides some rich ideas and perhaps even blueprints that can assist educators in re-creation or adaptation of this teaching strategy within their own setting. Each article is unique, sharing a setting for the reader with special tips and considerations, as well as items needed to ensure a well-developed scenario. Simulations Ready to Use articles have been a category of some Simulation & Gaming issues the past few years. These types of articles often share research findings on existing simulations and games, and in many cases have also served as a sort of instruction manual. Likewise, some of the authors in this symposium provide detailed instructions of how they set up and piloted their escape rooms. As part of the piloting process, many of them assessed the impact that the escape rooms had on learning and provided the results of their pilot studies. This process is important and may lead to assessing the value of escape rooms through larger-scale multidisciplinary research.

The simulation community needs additional guidelines for fostering active engagement in the emerging technologies and science. To meet the need for escape room teaching strategies, Anderson et al. (2020) provide a unifying definition and exploration of the use of the term Escape Room. They encourage simulationist to utilize published terms rather than creating new terms, which advances the terminology in simulation science. This article serves as the foundation of this special edition and provides educators with a common language for defining this learning strategy. They conclude their discussion by reinforcing the importance of reporting how best practices were utilized in the design and delivery of the escape rooms for learners.

As implied earlier in this editorial, the intent of the articles in this symposium is to encourage and guide further application and testing of escape rooms as a teaching strategy for multiple disciplines. In their article, Eukel and Morrell (2020) provide a starting point for creating, piloting, and evaluating new content being delivered in this fashion. Readers will find this article useful for operationalizing ideas, while following best practices in the delivery of an escape room, which can be applied to all disciplines. Healthcare is a multifaceted environment that immerses multiple disciples in all aspects of clinical care. Team-based learning can engage members of the group, which proved beneficial in McLaughlin, Reed, Shiveley and Lee’s (2020) article. The article serves as an exemplar of incorporating corporate policy in central orientation for all healthcare teams. Special considerations are discussed for incorporating laws and local stipulations in an escape room.

Spears, et al. (2020) offer the readers an opportunity to enhance critical thinking related to concepts such as legal implications, communication and teamwork. The authors package pediatric nursing content within the context of litigation and protection under Good Samaritan Laws. This type of engagement creates an invigorating environment about the legalities to consider when providing care for the public in a litigious society. Attention to the details in the debriefing and guided reflection of this content is needed as laws vary per country and state.

Depending on the academic institution and the curriculum, teamwork and communication may be embedded within simulation-based education (SBE). A few authors addressed some strategies for including these competencies in their escape rooms. Sarage and Eaton (2020) aligned effective communication to and medication administration in an undergraduate setting to improve patient safety. Valdes (2020) also explored the phenomenon of leadership and teamwork in a pilot study. The initial results show a positive impact of using this novel escape room teaching strategy. Sanders, et al. (2020) also recognized the need for teaching teamwork. They suggest that using escape rooms in the manner they describe can lead to more engagement because all members of the team must become involved in the escape process. They suggest adding a game manager, useful for the deconstruction of the elements within the escape room for the learners. In addition, Morrell and Eukel (2020) suggest that the facilitator closes the learning loop in a structured debrief, in accordance with simulation best practices. They highlight how their cardiovascular escape room led to student reflections of growth in teamwork and other areas during this time.

The ability to use this somewhat new teaching strategy within a curriculum, providing content in a refreshing manner can potentiate learning. Smith and Davis (2020) use a virtual escape room as an interesting way to assist pre-licensure nurses in preparation for pharmacology exams and content. Smith and Davis observed that clinical judgement opportunities could be incorporated through the activities in their escape room. They highlight the assessment and interventions a nurse needs to accomplish in order to escape the room and be successful.

As we highlighted, and this is emphasized by Anderson et al. (2020) and Eukel and Morrell (2020) a logical next step for many escape rooms is assessing the impact of these unique strategies. Some authors (Frederick & Reed, 2020; Hardie, et al. 2020; McLaughlin, et al., 2020) conducted pilot study research and found some positive results. Learners seem the enjoy the process of learning through escape rooms and there may be some gains in knowledge associated with this strategy. Therefore, as we aim for higher educational outcomes, any additional research should look at the return on investment that this strategy can produce for the organization.

Escape rooms offer educational and professional development in an entertaining venue, while continuing to provide key elements which by nature provoke engagement. The increased use of consistent terminology and reporting will solidify escape rooms as a validated teaching strategy. We are grateful for the authors in this symposium for sharing some of their escape room concepts. A big thank you to Dr. Desiree A. Díaz for facilitating this symposium and in many cases providing mentorship to newer author-researchers. As noted by several of the authors, while the framework or structure in unique to their goals and settings, educators may adapt the activities to a variety of other areas in and outside of healthcare simulation. We encourage multi-site and interdisciplinary implementation of escape rooms and hope that this symposium serves as some inspiration for larger projects and more rigorous research.