The Effect of Emergency Escape Room Simulation on Knowledge, Anxiety, and Satisfaction Levels of Students: A Randomized Controlled Trial
Clinical Snapshot
PICO Framework
| P — Population | Nursing students (n=40) at a university nursing faculty in Istanbul, Turkey |
| I — Intervention | Emergency escape room simulation intervention for emergency nursing education |
| C — Comparator | Traditional education method (no additional intervention) |
| O — Outcomes | Knowledge levels (measured immediately, 1 week, and 1 month post-education), anxiety levels (State Anxiety Scale), and satisfaction levels (Visual Analog Scale) |
Bottom Line
This small randomized trial (n=40) suggests escape room simulation may improve emergency nursing knowledge retention and student satisfaction compared to traditional teaching methods. The intervention showed sustained knowledge benefits at 1 month follow-up and reduced student anxiety. However, the study has significant methodological limitations including very small sample size, lack of confidence intervals, insufficient detail about randomization procedures, and inability to blind participants. While the concept is innovative and results promising, larger, more rigorously designed trials are needed before widespread implementation. The intervention appears feasible for Australian nursing programs but would require resource investment and curriculum integration planning.
Key Findings
P Value: P = 0.003 (immediate), P < 0.001 (1 week), P < 0.001 (1 month) for knowledge outcomes
Effect Size: Not reported - only statistical significance provided
Primary Outcome: Knowledge levels measured at immediate, 1 week, and 1 month post-intervention
Nnt Or Sensitivity: Not calculable from available data - effect sizes and baseline rates not provided
Confidence Interval: Not reported
Clinical Application
Moderate - requires development of escape room scenarios, trained facilitators, and appropriate physical or virtual spaces Highly relevant to Australian nursing education. Aligns with ANMAC standards for simulation-based learning and could enhance emergency preparedness training required by AHPRA registration standards Undergraduate nursing students in emergency nursing education programs
Abstract
BACKGROUND: The aim of this study is to determine the effect of escape room simulation intervention on the knowledge, anxiety, and satisfaction levels of students in emergency nursing education. METHODS: This randomized controlled study was conducted with 40 students studying at the nursing faculty of a university in Istanbul. The students in the intervention group (n = 20) were given an escape room simulation intervention related to emergency nursing education. The students in the control group (n = 20) were not given any intervention other than the traditional education method. Data were collected using the Knowledge Test, State Anxiety Scale, and Visual Analog Scale for satisfaction. RESULTS: The knowledge level of the students in the intervention group measured immediately after the education (P = 0.003), 1 week after the education (P < 0.001), and 1 month after the education (P < 0.001) was found to be significantly higher than that of the control group. While no significant difference was found in anxiety levels before and after the education between the groups, a significant difference was found in anxiety levels before and after the training in the intervention group (P < 0.001). The satisfaction level measured immediately after the education was found to be significantly higher in the intervention group than in the control group (P < 0.001). CONCLUSION: This study show that escape room simulation increased emergency nursing knowledge and satisfaction and reduced anxiety levels of the students. It is recommended that escape room simulation intervention be used in more studies in nursing education. The study was registered on ClinicalTrials.gov.tr with the number NCT06619119.
References
- 1.Ozel, H., & Akpinar, E. G. (2026). The Effect of Emergency Escape Room Simulation on Knowledge, Anxiety, and Satisfaction Levels of Students: A Randomized Controlled Trial. Games for Health Journal. https://doi.org/10.1177/2161783X251378638
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