Abstract

Background: Nursing education continues to evolve in response to the increasing complexity of healthcare practice. Competency-based education (CBE) has emerged as a leading framework aligning curriculum, learning experiences, and assessments to ensure graduates are prepared for professional practice. However, best practices for evaluating competency in nursing students are not established, and student perspectives are underrepresented. Understanding these perspectives is vital to inform effective evaluation strategies and advance CBE implementation in nursing education.

Purpose: This study explored undergraduate nursing students’ experiences participating in a maternal-newborn escape room designed as a comprehensive course evaluation activity.

Methods: A convenience sample of 115 undergraduate nursing students participated in a 90-minute escape room activity. Teams completed challenges and scenarios designed to promote application of key course concepts. Afterward, students completed the Simulation Design Scale (SDS), a validated 20-item tool assessing objectives/information, support, problem solving, feedback, and fidelity, and submitted written reflections. Quantitative data were analyzed using descriptive statistics and independent samples t-tests to compare semesters. Qualitative data underwent thematic analysis to identify key themes from student feedback.

Results: SDS scores indicated high levels of engagement and perceived realism. Qualitative findings support these results, with students emphasizing knowledge application in realistic, timed clinical scenarios. Participants reported improved teamwork, communication and appreciation for individual roles. The fast pace and variety of tasks sustained engagement, and many noted the activity better aligned with their learning styles compared to traditional exams. Students described the activity as a comprehensive, interactive way to demonstrate knowledge, clinical judgment and readiness for future practice.

Conclusions: An evaluative didactic escape room activity offers an engaging, realistic, and effective alternative to traditional evaluation methods in nursing education. Students connected applied learning from the activity to future clinical practice, identifying enhanced clinical judgment, collaboration, and communication. Integrating student feedback into curriculum design offers insight for evidence-based evaluation strategies supporting competency attainment and clinical preparedness.

Notes

References:

1. American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. American Association of Colleges of Nursing. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

2. Gonzalez, L., Nielsen, A., & Lasater, K. (2021). Developing students’ clinical reasoning: A faculty guide. Journal of Nursing Education (60)9, 485-593.

3. National League for Nursing. (2005). Simulation Design Scale (Student Version) ©. Retrieved from https://www.nln.org/education/teaching-resources/tools-and-instruments [nln.org]

4. Nowell, LS, Norris, JM, White, DE, & Moules, NJ. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16(1):1–13. doi.org/10.1177/1609406917733847

5. O’Rae, A., Peters, K., Shajani, Z, Burkett, J., and Laing, C. (2025). Improving the evaluation of clinical competence in undergraduate students, evidence and technology: An integrative review. Journal of Professional Nursing, 56, 19–25.

6. Woodworth, J. A. (2020). Escape room teaching pedagogy in the didactic learning environment for nursing. Nurse Educator, 46(1), 39-42.

Description

This study explored undergraduate nursing students’ experiences with an active learning escape room as an innovative evaluation method in a didactic course. Students reported high engagement, teamwork, and knowledge application. Findings suggest escape rooms offer a student-centered, engaging, effective alternative to traditional evaluations supporting competency-based assessment and promoting clinical reasoning.

Author Details

Cheryl A. Corbett, MSN, APRN, FNP-C; Shelly Jensen Reed, PhD, DNP, APRN, CNM, FAAN; Cori Reynolds, DNP, APRN, FNP-C

Sigma Membership

Iota Iota

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Mixed/Multi Method Research

Keywords:

Teaching and Learning Strategies, Testing Strategies, Curriculum Development, Competency-Based Education, Nursing Education, Nursing Skills--Education, Escape Room

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-30

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Discovering Innovative Didactic Evaluation Through an “Escape Womb”

Toronto, Ontario, Canada

Background: Nursing education continues to evolve in response to the increasing complexity of healthcare practice. Competency-based education (CBE) has emerged as a leading framework aligning curriculum, learning experiences, and assessments to ensure graduates are prepared for professional practice. However, best practices for evaluating competency in nursing students are not established, and student perspectives are underrepresented. Understanding these perspectives is vital to inform effective evaluation strategies and advance CBE implementation in nursing education.

Purpose: This study explored undergraduate nursing students’ experiences participating in a maternal-newborn escape room designed as a comprehensive course evaluation activity.

Methods: A convenience sample of 115 undergraduate nursing students participated in a 90-minute escape room activity. Teams completed challenges and scenarios designed to promote application of key course concepts. Afterward, students completed the Simulation Design Scale (SDS), a validated 20-item tool assessing objectives/information, support, problem solving, feedback, and fidelity, and submitted written reflections. Quantitative data were analyzed using descriptive statistics and independent samples t-tests to compare semesters. Qualitative data underwent thematic analysis to identify key themes from student feedback.

Results: SDS scores indicated high levels of engagement and perceived realism. Qualitative findings support these results, with students emphasizing knowledge application in realistic, timed clinical scenarios. Participants reported improved teamwork, communication and appreciation for individual roles. The fast pace and variety of tasks sustained engagement, and many noted the activity better aligned with their learning styles compared to traditional exams. Students described the activity as a comprehensive, interactive way to demonstrate knowledge, clinical judgment and readiness for future practice.

Conclusions: An evaluative didactic escape room activity offers an engaging, realistic, and effective alternative to traditional evaluation methods in nursing education. Students connected applied learning from the activity to future clinical practice, identifying enhanced clinical judgment, collaboration, and communication. Integrating student feedback into curriculum design offers insight for evidence-based evaluation strategies supporting competency attainment and clinical preparedness.