Effects of Using Escape Room as an Assessment Game on Critical Thinking and Self-efficacy in Clinical Performance of Nursing Students: A Randomized Clinical Trial

Abstract

Nurses work in a complex and dynamic environment. The traditional approach does not allow nursing students to experience real-life clinical problems and manage stress on a real-time scale. The present study aimed to determine the effect of using an escape room as an assessment game on critical thinking and self-efficacy in nursing students' clinical performance. Materials and Methods: This randomized clinical trial was conducted with the participation of 80sixth-semester nursing students in 2024. Sampling was done by convenience and random allocation of samples by card method including the intervention group (n=40) and control group (n=40). The intervention was an educational plan based on the use of escape rooms. Data collection was done using a standard self-efficacy questionnaire in clinical practice and a standard critical thinking questionnaire. The control group received routine educational programs. The obtaind data were analyzed using SPSS software (version 26) through descriptive and inferential statistics. Results: The results showed that critical thinking scores in the intervention group increased from 250.20±32.30 at the pretest to 261.20±23.10 at the posttest. However, this change was not statistically significant (P>0.05). Self-efficacy scores in the intervention group increased from 91.2±6.20 at pretest to 93.50±5.50 at posttest; however, it was not statistically significant (P>0.05). In the control group, scores decreased from 88.40±8.20 to 85.70±5.60. However, these changes were also not statistically significant (P>0.05). Conclusion: The results of the present study showed that using escape rooms as an educational method had positive effects on the critical thinking and self-efficacy of nursing students. However, these effects were not statistically significant and further studies are needed to investigate its long-term effects. Copyright © 2025 Avicenna Journal of Nursing and Midwifery Care.