UB builds escape room to teach nursing, pharmacy students teamwork

Published September 1, 2019

Escape rooms have reached the college classroom. To improve teamwork and communication between nursing and pharmacy students, the University at Buffalo School of Nursing and School of Pharmacy and Pharmaceutical Sciences have turned to the popular, mystery-themed game for interprofessional training.

Rather than a prison cell or abandoned home, groups of students are placed in a simulated medical clinic. Their goal: solve various puzzles to discover what ails their patient and provide the proper treatment. The game occurs in conjunction with a home health care simulation, allowing UB researchers to study the impact of the escape room on student performance.

Nursing and pharmacy students hold up a sign saying "we did it.".

Nursing and pharmacy students pose for a photo after successfully saving Patient X.

“Most people do escape rooms for entertainment, but they are also an objective way to evaluate teamwork and communication, something that we’ve struggled to do in our simulations,” said Kelly Foltz-Ramos, PhD, RN, FNP-BC, CHSE, RHIA, research assistant professor and director of simulation in the UB School of Nursing.

“Our room is not meant to be overly difficult. It’s meant to educate and teach students to appreciate each other’s strengths. Thirty minutes is a short period of time, but if they are successful, it could make a big difference everywhere, including the workplace.”

Foltz-Ramos organized the game, simulation and study with Nicholas Fusco, PharmD, clinical associate professor in the School of Pharmacy and Pharmaceutical Sciences.

“Communication is critical between nurses and pharmacists because both professionals have key information about patients that, when combined, can enhance the care that patients receive,” said Fusco.

“Nurses spend the most time among health care professionals one-on-one with their patients, and know them very well. Pharmacists have in-depth knowledge of drug therapies. When the two communicate, especially as it pertains to a patient’s treatment regimen, they can combine patient-specific and therapy specific factors together to come up with the best possible plan of care for their patients. It’s a win-win situation.”

Escape room clues.

Students use clues and solve puzzles to save Patient X.

To design their game, the researchers consulted with 5 Wits, a company with escape rooms across the Northeast, and even attempted one of their rooms.

Similar to other escape rooms, the UB room, named Patient X, features riddles, puzzles, combination locks and invisible ink. The game will highlight critical lessons surrounding infection control, patient restraint and medication safety.

Our room is not meant to be overly difficult. It's meant to educate and teach students to appreciate each other's strengths. - Kelly Foltz-Ramos

Students also take part in a simulation of a home health care meeting, similar to what they will encounter in the field. During the meeting, students work together to understand a patient’s adverse reaction to an incorrect dosage of medication and build a plan of recommendation for health care providers. A second home care scenario involved polypharmacy – a recently discharged patient was continuing medications prescribed in the hospital, but also had several prescribed medications at home. Students work to address discrepancies and to prevent this from occurring in the future.

Students work in the escape room.

Students work together to save Patient X before time runs out.

Of the nearly 250 students who participated during the fall 2018 semester, half completed the simulation first, and the other half began with the escape room. Students were divided into groups of four – two from each school — and received 30 minutes to solve each the game and simulation.

Participants complete a survey after the simulation, regardless of whether they completed the escape room. The results will help the researchers determine the effectiveness of team building exercises on performance and perceptions surrounding teamwork in interprofessional training.

Forty percent of these participants escaped; more importantly, the researchers found a significant increase in teamwork perceptions. There was also a shared positive experience among those who did not escape.

Foltz-Ramos and Fusco say that follow up will inform whether these positive perceptions are sustained over time. They would like to explore team dynamics and the participants’ acquisition of knowledge and skills related to the clinical topics. They are also interested in the possibility of including additional disciplines in the future.

Fusco said, “By creating learning experiences during their training where they can interact with other professional students, they can begin to build respectful relationships, understand each other’s professional roles and responsibilities, understand the values of each profession and practice working together as a team, with the ultimate goal of improving the health and wellness of individual patients and the community.”