Online ‘escape rooms’ as a teaching aid for nursing students during lockdown

These game-style escape rooms can be adapted to become innovative teaching tools, providing a unique way for students to learn or revise.

‘As an example, in the drug calculation room, we played intense music and had bells ringing, it was very dramatic. The students couldn’t concentrate, but it reflected clinical environments where you are often interrupted and have patient bells ringing,’ explains Johanna Rhodes, Head of Nursing at the Southern Institute of Technology (SIT).

Rhodes used the concept as part of the Bachelor of Nursing programme at SIT. She wanted to validate it as a learning strategy and ensure that it was worthwhile for students.

‘The driving force behind my whole teaching philosophy is realism, so the escape room concept is great because it offers a way to learn or revise in an environment that we can manipulate to mimic some of the real-world stresses of a career in nursing,’ says Rhodes.

She first introduced an on-campus escape room learning tool in 2019. At this point she undertook the first of two research projects to ascertain their effectiveness as a learning tool. She also wanted to include the student voice as this was limited in the existing literature on the topic. Her first project found – through an online questionnaire – that the on-campus escape rooms were well received by the students, and anecdotally had a significant impact on their learning.

When New Zealand entered lockdown due to COVID-19 in March 2020, Rhodes pivoted from on-campus escape rooms to an online alternative hosted on Google Docs.

‘We suddenly had to adapt this incredible classroom atmosphere to an online platform, and I decided to conduct similar research about the online version as we wanted to know if it was still a worthwhile teaching method to use,’ explains Rhodes.

Like the on-campus escape rooms, students had to complete an activity in each online ‘room’ before they could move to the next room, and eventually escape. Rhodes incorporated video and sound files and included a dramatic soundtrack. Unlike the on-campus challenge, students did not work in teams, but could choose to use ‘Blackboard Collaborate’ to work with others in the class to solve the problems. The purpose of each room was to reinforce current learning, and students could return to the virtual escape rooms before exams as a form of revision.

‘They were all trying to escape, and then when they did, they were still trapped in their houses under lockdown, it was quite ironic,’ says Rhodes.

Although the online escape research survey was optional, all 42 third year nursing students who participated in the class took part in the research. Data was collected immediately after the students completed the activity using an online survey on Blackboard.

Rhodes’ first research question asked one thing they learnt and one word to describe the experience. The second set of questions were anonymised, and therefore given the greatest weight in the study. Using a four-point Likert scale, students responded to three questions, about their learning experiences, and the results were statistically analysed. A final open-ended question was included to allow students to share their opinions regarding their experiences. These results were thematically analysed. To ensure academic rigour, Rhodes also employed the aid of two staff uninvolved in the project to identify the themes.

‘One of the standout themes was that the students said they had learnt about themselves working under pressure, some had to turn the music off because it was so annoying. Many students felt pressure even though they were sitting in their lounge and they were aware there was no real pressure,’ says Rhodes.

Students reported feeling an obligation to their colleagues to escape and a feeling that ‘this patient is depending on me.’ Students felt both challenge and frustration but agreed that it contributed to their learning and it was a positive experience.

Rhodes is currently writing up the results of her online escape room research for publication and presentation.

‘It will add another effective tool to the tool kit – one that works in a virtual environment,’ says Rhodes.

She is returning to on-campus escape rooms in 2021, with the online rooms available as optional revision tools for students later in the year.

Other schools at the Southern Institute of Technology, are considering adopting their own escape room learning aids as a result of her research.

A significant benefit of the initial 2019 study has been the collaboration that came after the results were published. An informal network now shares escape room resources nationally and internationally via a Facebook group, of which Rhodes encourages New Zealand colleagues to join.

• See Rhodes’ paper on her on-campus escape room research - Students’ perceptions of participating in educational escape rooms in undergraduate nursing education, Kai Tiaki Nursing Research, New Zealand Nurses Organisation, Vol. 11, No. 1, November 2020, p34-41.
  
  
• Find out more or join the Nurse Educators group on Facebook 
  
  
• Johanna Rhodes is the Head of School of Nursing at the Southern Institute of Technology, and a PhD candidate at Central Queensland University. She believes that in this tempestuous period of change, embracing teaching pedagogy reflective of the ‘real world’ is critical to progressing graduates who are equipped to work in the electrifying, intricate, and fluctuating area of healthcare. The use of simulation modalities in education offers a willingness to advance the aesthetic narrative of healthcare, while embracing realism. Simulation in education is Johanna’s research focus alongside being inventive with her management and teaching, offering continued innovation in nursing education. Contact Johanna Rhodes. 
  
  
• Visit SIT's website.