The Effect of Escape Room Method in Nursing Process Teaching

NCT ID: NCT07143643

Last Updated: 2025-12-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-19

Study Completion Date

2026-02-28

Brief Summary

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This study will be conducted to determine the effectiveness of education provided through the educational escape room method in nursing process teaching and to examine its effects on 4th-year nursing students' self-efficacy, teamwork, and anxiety.

Detailed Description

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To improve and maintain the quality of nursing care, practices should be based on theoretical knowledge and carried out using the Nursing Process, which is a systematic scientific method. In line with the Nursing Process, the nurse plans, implements, and evaluates nursing interventions for the nursing diagnoses identified through the analysis and evaluation of the data collected regarding the health care needs of the healthy or ill individual. In addition to ensuring individualized and holistic care, the Nursing Process offers many benefits such as promoting critical thinking skills among nurses, enabling efficient use of time and energy in care delivery, distinguishing nursing practices from those of other health care professionals, and making nursing practice more visible. However, national and international studies emphasize that there are both individual and institutional barriers to the use of the Nursing Process in practice. In fact, related studies indicate that nurses experience difficulties in the diagnostic phase of the Nursing Process, particularly in making accurate nursing diagnoses and identifying etiological/related factors.

Therefore, it is important for nurses to acquire the necessary knowledge and skills for implementing nursing care in line with the Nursing Process during their nursing education. Nevertheless, studies have reported that students face challenges in understanding, planning, and applying the Nursing Process due to deficiencies in theoretical knowledge, practice, and experience, as well as inadequate problem-solving skills and difficulties in communication with health care professionals. In this context, it is recommended to incorporate active learning methods that complement traditional teaching methods in nursing education to ensure that nursing students understand and apply the importance of providing appropriate nursing care in accordance with the Nursing Process.

One of the active learning methods that has gained popularity in recent years is the educational escape room method. Educational escape rooms are designed to enable students to achieve specific learning outcomes by finding clues, solving puzzles, completing tasks within a limited time, and working collaboratively. The aim of this collaborative game is usually to escape from the room or to find a specific object. Escape rooms have been shown to significantly improve students' critical thinking and decision-making skills by encouraging them to analyze, evaluate, and solve problems, as well as contributing to the development of problem-solving skills and team collaboration. Among the skills that determine and strengthen problem-solving ability is self-efficacy; however, no study has been found that examines the effect of educational escape rooms on self-efficacy. Furthermore, the literature notes that the time limitation in this method may cause stress and anxiety among participants, yet some studies indicate that it can also reduce students' anxiety. Therefore, further research is needed to investigate the effects of educational escape rooms on self-efficacy and anxiety.

Although the literature on teaching the Nursing Process includes studies using active teaching methods such as virtual games, simulation, and web-based instruction, no study has been identified regarding the escape room method. It is believed that the use of the educational escape room method, an innovative active learning approach that complements traditional methods in teaching the Nursing Process, may be an effective strategy. Indeed, in line with the objectives of undergraduate education, nursing students are expected to graduate as professionals capable of implementing nursing care through the Nursing Process. In this regard, it is of critical importance to repeat interventions and trainings related to the teaching of the Nursing Process before students graduate. Within this scope, the present study will be conducted to determine the effectiveness of education provided through the educational escape room method in nursing process teaching and to examine its effects on 4th-year nursing students' self-efficacy, teamwork, and anxiety. This research will be conducted in a randomized experimental design with pretest-posttest experimental and control groups.The study sample will consist of senior nursing students who meet the inclusion criteria and agree to participate in the study. The students included in the sample will be randomly assigned to either the experimental or control group. The sample size of the study was calculated using a power analysis. Based on the data of a referenced study, the analysis indicated that with an effect size of 1.03, a power of 99%, and a significance level of 0.05 with a confidence interval, the required sample size was determined to be 62 fourth-year nursing students (a minimum of n=31 students per group). In order to increase the reliability of the study and to allow the use of parametric tests, the total sample size was determined as n=70, with 35 students in the experimental group and 35 students in the control group, taking into account possible data losses (such as dropouts). Randomization will be achieved through simple random sequencing using a randomization method. Participants will be randomly assigned to the experimental and control groups.Data will be analyzed using the SPSS (Statistical Package for Social Sciences) version 25.0 software. Data will be collected through the "Student Information Form," "Nursing Process Knowledge Test," "Self-Efficacy for Clinical Performance Scale," "Collaboration Scale," "State-Trait Anxiety Inventory," and the "Quality Measurement Tool for Nursing Diagnoses, Interventions, and Outcomes."

Conditions

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Nursing Education ESCAPE ROOM Nursing Students

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized Controlled Trial
Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control group

Control group: Within the scope of the theoretical training on the nursing process, a two-week education will be provided. Afterwards, using the traditional teaching method, five groups of seven students each will examine the same case scenario applied to the experimental group within the framework of the nursing process for 60 minutes. The groups will work independently of each other in the same classroom environment and, together with the researcher, will analyze the case within the framework of the nursing process for 60 minutes using traditional teaching methods such as question-and-answer and discussion.

Group Type NO_INTERVENTION

No interventions assigned to this group

Participant Group

Experimental: Escape room simulation group- Within the scope of the theoretical training on the nursing process, a two-week education will be provided. Afterwards, the students in this group will be divided into five groups of seven students each and will participate in an escape room game based on a case prepared regarding the nursing process.

Group Type EXPERIMENTAL

Excape room game

Intervention Type OTHER

Application of Research:The escape room game scenario prepared by the researchers was designed according to the steps of the Nursing Process. The game consists of five stages, each conducted at different stations, and each stage includes various clues and activities. The stages were organized to cover the steps of the Nursing Process: "Assessment, Nursing Diagnosis, Planning, Implementation, and Evaluation." Before starting the game, the students who will participate will be informed about the expected objectives, the game rules, and the duration. In addition, it will be stated that each group must select a group leader. The students will be given a total of 60 minutes to answer the questions in each stage, assemble puzzle pieces, unlock locked boxes, follow the clues, and find the exit key in order to leave the room. The students will be expected to complete the tasks at the stations prepared in accordance with the Nursing Process stages and to exit the room within the allotted time.

Interventions

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Excape room game

Application of Research:The escape room game scenario prepared by the researchers was designed according to the steps of the Nursing Process. The game consists of five stages, each conducted at different stations, and each stage includes various clues and activities. The stages were organized to cover the steps of the Nursing Process: "Assessment, Nursing Diagnosis, Planning, Implementation, and Evaluation." Before starting the game, the students who will participate will be informed about the expected objectives, the game rules, and the duration. In addition, it will be stated that each group must select a group leader. The students will be given a total of 60 minutes to answer the questions in each stage, assemble puzzle pieces, unlock locked boxes, follow the clues, and find the exit key in order to leave the room. The students will be expected to complete the tasks at the stations prepared in accordance with the Nursing Process stages and to exit the room within the allotted time.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

•Actively attending face-to-face education during the dates when the study will be conducted

Exclusion Criteria

•Previous training with or familiarity with the educational escape room method
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bezmialem Vakif University

OTHER

Sponsor Role lead

Responsible Party

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Yasemin Kıyak Yorulmaz

Principal Investigator Phd candidate of nursing

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Aylin ÖZAKGÜL

Role: STUDY_DIRECTOR

Istanbul University - Cerrahpasa

Locations

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Bezmialem Vakif University

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Yasemin KIYAK YORULMAZ

Role: CONTACT

+90 536 480 54 89

Aylin ÖZAKGÜL

Role: CONTACT

Facility Contacts

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Yasemin KIYAK YORULMAZ

Role: primary

+90 536 480 54 89

References

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Chang YY, Chao LF, Xiao X, Chien NH. Effects of a simulation-based nursing process educational program: A mixed-methods study. Nurse Educ Pract. 2021 Oct;56:103188. doi: 10.1016/j.nepr.2021.103188. Epub 2021 Sep 3.

Reference Type RESULT
PMID: 34544010 (View on PubMed)

Ordu Y, Caliskan N. The effects of virtual gaming simulation on nursing students' diagnosis, goal setting, and diagnosis prioritization: A randomized controlled trial. Nurse Educ Pract. 2023 Mar;68:103593. doi: 10.1016/j.nepr.2023.103593. Epub 2023 Mar 2.

Reference Type RESULT
PMID: 36871387 (View on PubMed)

Chen D, Liu F, Zhu C, Tai C, Zhang Y, Wang X. The effect of an escape room game on college nursing students' learning attitude and game flow experiences in teaching safe medication care for the elderly: an intervention educational study. BMC Med Educ. 2023 Dec 12;23(1):945. doi: 10.1186/s12909-023-04961-3.

Reference Type RESULT
PMID: 38087301 (View on PubMed)

Molina-Torres G, Sandoval-Hernandez I, Ropero-Padilla C, Rodriguez-Arrastia M, Martinez-Cal J, Gonzalez-Sanchez M. Escape Room vs. Traditional Assessment in Physiotherapy Students' Anxiety, Stress and Gaming Experience: A Comparative Study. Int J Environ Res Public Health. 2021 Dec 3;18(23):12778. doi: 10.3390/ijerph182312778.

Reference Type RESULT
PMID: 34886502 (View on PubMed)

Rushdan EE, Mohamed MAE, Abdelhalim GE, El-Ashry AM, Ali HFM. 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.

Reference Type RESULT
PMID: 39566365 (View on PubMed)

Quek LH, Tan AJQ, Sim MJJ, Ignacio J, Harder N, Lamb A, Chua WL, Lau ST, Liaw SY. Educational escape rooms for healthcare students: A systematic review. Nurse Educ Today. 2024 Jan;132:106004. doi: 10.1016/j.nedt.2023.106004. Epub 2023 Oct 24.

Reference Type RESULT
PMID: 37924674 (View on PubMed)

Gonzalez-de la Torre H, Hernandez-De Luis MN, Mies-Padilla S, Camacho-Bejarano R, Verdu-Soriano J, Rodriguez-Suarez CA. Effectiveness of "Escape Room" Educational Technology in Nurses' Education: A Systematic Review. Nurs Rep. 2024 May 13;14(2):1193-1211. doi: 10.3390/nursrep14020091.

Reference Type RESULT
PMID: 38804424 (View on PubMed)

Kalu F, Wolsey C, Enghiad P. Undergraduate nursing students' perceptions of active learning strategies: A focus group study. Nurse Educ Today. 2023 Dec;131:105986. doi: 10.1016/j.nedt.2023.105986. Epub 2023 Oct 17.

Reference Type RESULT
PMID: 37857101 (View on PubMed)

Rajabpoor, M., Zarifnejad, G. H., Mohsenizadeh, S. M., Mazloum, S. R., Pourghaznein, T., Mashmoul, A. & Mohammad, A. (2018). Barriers to the implementation of nursing process from the viewpoint of faculty members, nursing managers, nurses, and nursing students. Journal of Holistic Nursing and Midwifery, 28(2), 137-142.

Reference Type RESULT

Rajabpoor M, Zarifnejad GH, Mohsenizadeh SM, Mazloum SR, Pourghaznein T, Mashmoul A, Mohammad A. Barriers to the implementation of nursing process from the viewpoint of faculty members, nursing managers, nurses, and nursing students. J Holist Nurs Midwifery. 2018;28(2):137-42.

Reference Type RESULT

Other Identifiers

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YKİYAK

Identifier Type: -

Identifier Source: org_study_id

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