Using Escape Rooms for Nurse Education

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nurses working together to find a solution


Lecture-based education is the norm in many fields, including nursing. But studies suggest that lectures are not always the most effective way to engage students. The National Association of Colleges and Employers (NACE) reports that according to a recent survey, more than half of all Americans feel that they learn best through hands-on participation. This preference may be especially true for Generation Z (millennial) students, who are proven to have shorter attention spans, on average, than previous generations.

Educational institutions interested in meeting the needs of today’s students are looking for innovative, interactive ways to create productive learning environments. One method that has attracted attention in recent years is the use of escape rooms for nurse education. Escape rooms are a popular recreational activity in which participants are closed into a room, then presented with a storyline and a series of problems and challenges. If all problems are solved within a fixed timeframe, the participants “win” and are released from the room; if not, they “fail” the challenge.

With its problem-solving focus, the medical field is a natural fit for this type of activity. Academic programs such as Duquesne University’s Nurse Education & Faculty Role MSN can prepare future nurse educators to use creative tools to enhance nurse collaboration and make learning both fun and effective. Also offering Post-Master’s Certificate programs to meet the needs of all healthcare providers, Duquesne’s MSN curriculum uses many techniques to prepare nurse educators for success.

How It Works

An article titled “Bringing Escape Room Concepts to Pathophysiology Case Studies” by S. Richelle Monaghan, PhD and Scott Nicholson, PhD, explains that, when used in an educational setting, an escape room experience has three phases:

Scenario overview.

Before starting the challenge, participants are given an explanation of the fictional setting and situation they face. They are assigned an ultimate goal and told that they will have to solve a series of problems to reach it. They are also told that after each problem is solved, they will receive information that will help them with their next task.

The challenge.

The challenge is the game-like portion of the escape room challenge. Participants have a fixed amount of time to complete a slate of tasks. They may or may not be allowed to ask for hints, depending on the design of the challenge.


The debriefing phase, which occurs after the escape room challenge is finished, is unique to the educational setting. In it, the instructor presents a series of planned questions that spur discussion. Students have the opportunity to share their thoughts and perspectives on the experience. “It is a way for students to reflect, share, expand and connect more deeply with the learning aspect of the escape [experience],” the article explains.

Within this three-phase framework, educators are free to develop any storyline that strikes their fancy. Quandaries of diagnosis, medical crises, and issues with patient management are all topics that lend themselves to nursing-themed escape rooms.

One organization, for example, created an escape room in which a patient arrives in a hospital ER with nonspecific but potentially fatal symptoms. Escape room participants must earn clues that will help them make the correct diagnosis before the patient dies. The storyline of another escape room concerns a biological terrorist who accidentally exposes himself to his own biological agent. Participants must determine the agent and decide how to treat the terrorist within the allotted time-frame.

Educational Benefits

Do “games” like these really help participants to learn? The evidence suggests that they do. The Penn Medicine Sepsis Alliance recently staged an escape room with a storyline involving a sepsis patient who must be correctly treated with the right combination and order of medications. In a 2019 article, the Alliance discussed some of its takeaways from the event:

Cross-discipline collaboration.

The Alliance event attracted healthcare workers from a wide variety of fields. Participants included physical therapists, nursing assistants, nursing students, social workers, physicians, and infection team specialists. These professionals were forced to collaborate in a way that did not always occur in the real-world work environment. This experience built connection and exposed participants to new perspectives and knowledge.

Variety of learning methods.

Escape rooms effortlessly accommodate all three learning styles: visual, auditory, and kinesthetic. Participants can see, hear, and touch the clues, meaning that every type of learner can benefit.

Performance under pressure.

Escape room participants are performing under time pressure. This situation is not generally the case in traditional academic settings, but it is very common in the workplace. Escape rooms therefore foster the type of fast, on-your-feet thinking that is relevant in the real world.

The novelty factor.

Novelty makes a lasting impression, and participants found the escape room approach very novel indeed. By creating a memorable experience, organizers greatly boosted the retention factor of a somewhat dry concept.

Development Considerations

After hearing about the many potential benefits of educational escape rooms, nurse educators may wish to incorporate this tool into their teaching. Monaghan and Nicholson suggest that anyone developing an escape room should take certain factors into account:

The role of the narrative.

The storyline of an escape room provides context that can be lost in the classroom setting. A consistent, compelling narrative also keeps the participants interested and engaged in the tasks at hand.


In the educational setting, escape room activities must be squeezed into the allotted class period, leaving time for the preliminary overview and debriefing at the end. Alternately, the activity can take up one class period and the debriefing can be done during the next. Instructors should design experiences with their time constraints in mind.

Flow and complexity.

The best escape rooms start simple, then get more complex as participants warm to the challenge.

Playtesting and feedback.

Once designed, every escape room should be playtested with non-student volunteers to identify and then revise parts that might be confusing or otherwise ineffective.

Class size.

How many students do you need to accommodate? A small group of students can do an escape room together, all at once, but a larger student body may need to do it in shifts.

With these considerations in mind, creative nurse educators should be able to design an escape room that meets their students’ needs. They can look forward to a dynamic teaching/learning experience with good educational outcomes as a result.

About Duquesne University’s Master of Science in Nursing Program

Duquesne University’s online master’s in nursing programs prepare RNs in all stages of their careers to become nurse educators, forensic nurses, and family nurse practitioners. The university offers both MSN and Post-Master’s Certificate programs in all three concentrations and provides one-on-one faculty support to encourage academic success.

The university’s MSN in Nursing Education and Faculty Role prepares graduates for the Certification for Nurse Educators (CNE) exam. For more information, contact Duquesne University today.



Shortcomings of lecture-based education – NACE

Three phases – Scott

Diagnosis escape room example – Scott

Sepsis patient escape room example – Diversity Nursing

Educational benefits – Health Leaders

Development considerations – Scott