A Didactic Escape Game for Emergency Medicine Aimed at Learning to Work as a Team and Making Diagnoses: Methodology for Game Development

Effectiveness of "Escape Room" Educational Technology in Nurses' Education: A Systematic Review

Escape room games are educational gamification technologies that consist of introducing a team of players into a physical or digital space in search of clues to answer puzzles, riddles or enigmas and solve a mystery or problem. This study aims to determine the effectiveness of escape room games on the training of nursing students in an international context. A systematic review was carried out in MEDLINE, WOS, SCOPUS, CINAHL and LILACS databases using the MeSH terms "Education, Nursing" and "Educational Technology", and the free term "Escape room", combined with Boolean operators AND/OR. Intervention studies in Spanish, English and Portuguese were included, without limitation for the year of publication. Selection and critical appraisal were conducted by two independent reviewers. A total of n = 13 interventional studies were included (n = 2 Randomized Clinical Trials and n = 11 quasi-experimental design). Escape rooms are a recent and growing educational methodology, increasingly used in academia and in the training of nurses and nursing students. However, it is necessary to expand their use and the quality of the studies in a greater number of contexts. Furthermore, it is necessary to homogenize and standardize validated instruments to evaluate the effectiveness of escape rooms in the nursing education area.

Game design elements of serious games in the education of medical and healthcare professions: a mixed-methods systematic review of underlying theories and teaching effectiveness

Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game's effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements' underlying theories will be worked out, and third, the game design elements' effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games.

A scoping review of international allied health professions escape room practices and scholarship

PURPOSE

The purpose of this scoping review is to assess the literature on allied health professions escape rooms (AHPERs), investigating their common purposes and practices, and the trends in scholarship.

METHODS

This scoping review followed PRISMA-ScR guidelines to assess the size and scope of evidence in the literature, categorize common purposes and practices, and explore trends in AHPER scholarship. Two reviewers developed a review protocol, collected literature using a search strategy aligned with inclusion criteria, and charted review results.

RESULTS

The literature search yielded 6,170 articles. After the final review, 34 unique records met inclusion criteria. Studies were conducted in the United States, Spain, Australia, France, Brazil, and Canada. Most escape rooms reported participants, team size, puzzle type, and outcomes, but few used causal research designs, primarily using pre-post with no control designs. AHPERs represent an increasingly popular pedagogical approach. AHPERs tend to be simply structured, patient themed, and convey either disciplinary or interprofessional lessons. Generally, AHPERs were self-reported as effective and satisfying, but scholarship supporting AHPERs was insufficient in design for causal claims.

CONCLUSION

Developers and scholars may benefit from considering frameworks and guidelines for consistent creation and increased trustworthiness in the AHPER practice and knowledge base. Where AHPER scholars can increase attention to learning outcomes, and plan scholarly works in advance of the escape room, the AHPER body of knowledge will increase.

Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022

BACKGROUND

The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy.

METHODS

Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded.

RESULTS

Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs.

CONCLUSION

These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.

Evaluation of the Performance of a Card Game to Introduce Students to Interprofessional Collaboration: A Randomized 2-Group Comparison Study

BACKGROUND

Gamification is an approach that can be used to introduce interprofessional collaboration in nursing and health science. Card games are an effective and convenient way to educate students about clinical professions.

PURPOSE

We compared the perception of an experimental group of students who played an educational card game to a control group that played an uninstructive card game.

METHODS

College students (n = 148) from nursing and health science majors consented to play a 30-minute card game and complete a 13-item survey.

RESULTS

Perceptions of the card game were significantly better for students in the experimental group who played the interprofessional collaboration game than for those in the control group (t = 10.33, P < .001). Survey subscales were rated significantly higher for respondents who played the interprofessional card game.

CONCLUSIONS

The use of an innovative card game teaching strategy significantly increased the perception of interprofessional collaboration among college students.

Influence of Gamification and Cooperative Work in Peer, Mixed and Interdisciplinary Teams on Emotional Intelligence, Learning Strategies and Life Goals That Motivate University Students to Study

It is necessary to motivate university students to reduce the dropout rate in Spain, and to look for strategies that help university students acquire professional competencies; this is where gamification can be useful. The purpose of the study was to evaluate the influence of a learning methodology based on gamification and cooperative work in peers, and in mixed and interdisciplinary teams on the emotional intelligence, learning strategies, and life goals that motivate university students to learn. The sample consisted of 102 students who took a subject with a gamification-based methodology, through the Mechanics-Dynamics-Aesthetics model, in a cooperative way. The Self-Perception Scale of Personal Academic Motivation and the Trait Meta Mood Scale 24 were used. The results of the study showed an increase in learning strategies and life goals that motivated university students to study, as well as increases in emotional clarity and significantly in emotional repair. It was concluded that gamification is a positive tool for its ability to increase emotional intelligence, life goals, and learning strategies in university students' motivation to learn.

An evaluation of undergraduate student nurses' gameful experience whilst playing a digital escape room as part of a FIRST year module: A cross-sectional study

BACKGROUND

The circumstances arising from the COVID-19 pandemic have accelerated the use of digital teaching and learning in health professions education. Digital gamification-based teaching and learning activities are innovative and versatile tools for the acquisition of professional competencies in higher education, which can be used on a range of topics and can be supplemental to other teaching methods.

OBJECTIVES

This study aimed to investigate nursing students' gameful experience whilst playing a digital escape room. In addition, we aimed to analyze the students' motivation, learning experience and outcome of the activity, and the students' perception of the degree of achievement of the intended learning outcomes.

DESIGN

Cross-sectional descriptive study.

PARTICIPANTS

A total of 136 undergraduate first year student nurses enrolled in a "Fundamentals of Nursing" course.

METHOD

The digital escape room game took place online during the academic year 2020-2021. The measures included the GAMEX scale in its Spanish version and a self-reported questionnaire to evaluate the outcome of the scape room game and the degree of achievement of the intended learning outcomes.

RESULTS

More than 80 % of the participants were moderately to very motivated to play the game. Three GAMEX dimensions achieved a mean score of 3 or above 3, namely Enjoyment, Creative Thinking and Absence of Negative effects. The mean score for each of the outcome variables was over 3. However, the degree of achievement of the learning outcomes after exiting the digital escape room was uneven.

CONCLUSION

Gamification-based teaching and learning activities, such as digital escape rooms, can be effective in fostering specific skills, including teamwork, communication and critical thinking. However, they should be designed carefully, and used as a complement, rather than a substitute, of other educational activities.

Nouvelle méthode pédagogique en médecine d’urgence : l’escape game

La mise en application de la réforme du second cycle confirme aujourd’hui la place importante de l’approche par compétences dans l’éducation en santé depuis l’application de la réforme du second cycle. La médecine d’urgence, via son exercice interprofessionnel, nécessite une grande agilité éducative. Pour cette équipe, composée de professionnels de différents horizons (médecin, infirmier, ambulancier), pour travailler ensemble et être efficient pour le patient, deux points sont essentiels : la communication et la planification. Il semble exister un besoin de formation à ces compétences non techniques. Des innovations pédagogiques permettraient d’étendre l’éventail des possibilités formatives et d’accroître la formation à ces compétences. La gamification est le fait d’appliquer des concepts de jeu à des éléments initialement non ludiques. Elle est ancrée dans les approches d’apprentissage actif et se développe actuellement dans l’éducation à la santé. L’escape game, impliquant de petits groupes de cinq à dix personnes devant ensemble résoudre une énigme, se développe de plus en plus dans le champ de l’éducation, y compris en santé. Il semble intéressant d’utiliser l’escape game comme outil éducatif pour former les équipes de médecine d’urgence sur le thème du travail d’équipe et de la communication interprofessionnelle. En effet, cet outil peut permettre de faciliter l’enseignement des compétences non techniques. L’implémentation de ces outils pédagogiques novateurs serait un réel atout pour les facultés de médecine et les instituts universitaires. Elle serait complémentaire aux autres méthodes pédagogiques utilisées comme la simulation.