The Impact of an Escape Room Simulation to Improve Nursing Teamwork, Leadership and Communication Skills: A Pilot Project

Background.: Commercial escape room simulation-based educational experiences were piloted on a cohort of ten RN-BSN students to determine the effect on mastery of communication, leadership, and teamwork skills. Methods.: Pre-test/post-test research design and qualitative questions were used to measure the impact of an escape room simulation activity on teamwork, communication, and leadership skills. The Team Strategies and Tools to Enhance Performance and Patient Safety^® Teamwork Attitudes Questionnaire, and self reported levels of confidence and competence questionnaire were administered pre/post escape room simulation to measure communication, team structure and leadership skills. The University of Miami-Crisis Resource Management tool was utilized to measure observed teamwork. Additionally, four open-ended qualitative self-reflective questions were asked following the escape room. Results.: Data from the analysis of the pre and post observations of simulation encounters found statistically significant time dependent differences noting improvements in observed teamwork and leadership, p <.001, pre-mean 18.5, post-mean 35.0. Qualitative data revealed the participants found the escape room simulation to be an engaging teaching method to master teamwork and leadership skills. Conclusion.: This pilot study sets the foundation for future use and exploration of escape room experiences to teach teamwork, communication, leadership and situational awareness. Following the escape room simulation, observed improvements in teamwork and leadership were found. Participants found the escape room activity to be an engaging experiential teaching method to promote attainment of critical skills needed to work as an effective member of a team. Study findings suggest that the use of an escape room can impart experiential learning with critical skills needed to work as an effective member of a team. As a result of this pilot study, nursing faculty developed an escape room simulation experience that was initiated the following semester.