Efficacy of Gamification With Escape-Room for Arrhythmia Identification in Critical Patients

July 8, 2024 updated by: Marcia Cristina da Silva Magro, University of Brasilia

Efficacy of Gamification With Escape-Room for Arrhythmia Identification in Critical Patients: an Experiment With Nursing Undergraduates

Introduction: Health education provided through the escape-room is still a recent approach in educational methodology and tends to be a strategy that benefits nursing students, particularly in gaining knowledge and skills. However, few studies have explored the use of both in-person and virtual escape-room as an educational methodology in nursing. Objective: To assess the effectiveness of the gamification strategy through the in-person escape-room model compared to the virtual model in enhancing cognitive and affective competencies for recognizing cardiac arrhythmias in critical care patients within the nursing field. Method: A randomized clinical trial to be conducted with nursing students from higher education institutions in the Federal District, Brazil. Students will undergo a theoretical class on cardiac arrhythmias in critical patients and will then be randomized to experience either the in-person or virtual escape-room scenario. Knowledge tests, the Depression, Anxiety, and Stress Scale, Satisfaction and Self-confidence Scale in nursing management learning, and perceived gains will be administered pre and post-intervention. Results with p≤0.05 will be considered significant. Expected Results: It is anticipated that this study will contribute to the enhancement and broadening of cognitive and affective competencies in nursing students, improving the quality of care through an active educational strategy like the escape-room, and consequently reducing costs for the Unified Health System by minimizing errors in recognizing clinical changes in critical patients. Additionally, the study aims to address gaps in understanding the use of educational escape-rooms in the field of nursing.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
53

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Brazil
    • DF
      • Brasília, DF, Brazil, 71938360
        • Recruiting
        • Alberto Augusto Martins Paiva
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Students enrolled in the undergraduate nursing program who have successfully completed the course related to adult and elderly health.

Exclusion Criteria:

  • Healthcare professionals, including those participants who, at any point during the research stages, choose to withdraw or who have not completed/participated in one of the study phases.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Other: Knowledge Test
Behavioral: In-person Escape Room
The in-person escape room will be conducted in the nursing laboratory of a Higher Education Institution (HEI), equipped with a high-fidelity mannequin to simulate a critical patient and create a realistic environment. Participants will be divided into groups, with one group entering at a time as requested. During the in-person escape room, participants will interact with the patient mannequin, hospital equipment and devices, as well as with objects and clues in the environment. The game duration will be 30 minutes to ensure equal conditions among participants and prevent time distortions. Interactions and participants' performance will be recorded by the facilitator, guiding the feedback.
Behavioral: Virtual Escape-Room
The virtual escape room will be conducted in a classroom of an HEI, utilizing an online platform that allows the virtual reproduction of the game. Each group will have access to a tablet or computer to participate in the game provided by the researcher. During the game, participants will interact with the platform interface and solve challenges to escape the virtual room within 30 minutes. Thus, each group will have a maximum of 30 minutes to complete the escape room, ensuring equal conditions among participants. Records of interactions and participant performance will be logged for later analysis and feedback.
Other: Knowledge Test Satisfaction and Self-Confidence Scale
Behavioral: In-person Escape Room
The in-person escape room will be conducted in the nursing laboratory of a Higher Education Institution (HEI), equipped with a high-fidelity mannequin to simulate a critical patient and create a realistic environment. Participants will be divided into groups, with one group entering at a time as requested. During the in-person escape room, participants will interact with the patient mannequin, hospital equipment and devices, as well as with objects and clues in the environment. The game duration will be 30 minutes to ensure equal conditions among participants and prevent time distortions. Interactions and participants' performance will be recorded by the facilitator, guiding the feedback.
Behavioral: Virtual Escape-Room
The virtual escape room will be conducted in a classroom of an HEI, utilizing an online platform that allows the virtual reproduction of the game. Each group will have access to a tablet or computer to participate in the game provided by the researcher. During the game, participants will interact with the platform interface and solve challenges to escape the virtual room within 30 minutes. Thus, each group will have a maximum of 30 minutes to complete the escape room, ensuring equal conditions among participants. Records of interactions and participant performance will be logged for later analysis and feedback.
Other: Perceived Gains Scale and DASS-21 (Depression, Anxiety, and Stress Scale-21)
Behavioral: In-person Escape Room
The in-person escape room will be conducted in the nursing laboratory of a Higher Education Institution (HEI), equipped with a high-fidelity mannequin to simulate a critical patient and create a realistic environment. Participants will be divided into groups, with one group entering at a time as requested. During the in-person escape room, participants will interact with the patient mannequin, hospital equipment and devices, as well as with objects and clues in the environment. The game duration will be 30 minutes to ensure equal conditions among participants and prevent time distortions. Interactions and participants' performance will be recorded by the facilitator, guiding the feedback.
Behavioral: Virtual Escape-Room
The virtual escape room will be conducted in a classroom of an HEI, utilizing an online platform that allows the virtual reproduction of the game. Each group will have access to a tablet or computer to participate in the game provided by the researcher. During the game, participants will interact with the platform interface and solve challenges to escape the virtual room within 30 minutes. Thus, each group will have a maximum of 30 minutes to complete the escape room, ensuring equal conditions among participants. Records of interactions and participant performance will be logged for later analysis and feedback.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Evaluate the feelings of stress and anxiety among nursing students after experiencing the in-person and virtual escape-room combined with an interactive lecture
Time Frame: 3 months
The Depression, Anxiety, and Stress Scale (DASS-21) will be necessary to assess the impact of the intervention on the stress experienced by students during the process. The scale consists of 21 items, with seven items in each of the three scales (depression, anxiety, and stress). The minimum and maximum scores for each subscale are determined by the sum of the values assigned to the corresponding items. Generally, for each of the three subscales, the minimum possible score is 0, indicating the absence of symptoms, while the maximum score varies depending on the intensity of the responses provided by participants to specific items. For example, on a scale of 0 to 21 for each subscale, a higher score suggests higher levels of depression, anxiety, or stress.
3 months
Perceived Gains Scale
Time Frame: 3 months
Another instrument that will be used in the study is the Perceived Gains Scale, which consists of 25 items with 5 response options: Improved immensely; improved considerably; improved slightly; stayed the same; got worse. In this scale, the different variables identify students' perceptions of the gains achieved through their experience with high-fidelity patient mannequins at the cognitive level.
3 months
Student Satisfaction and Self-Confidence in Learning
Time Frame: 3 months
The "Student Satisfaction and Self-Confidence in Learning" Scale was developed to measure individuals' satisfaction and self-confidence acquired through high-fidelity simulations. This instrument has been validated in Brazil and will be used in the present study following the intervention. The scale consists of 26 items, organized into five factors: the usefulness and effectiveness of teaching methods, the provision of didactic materials and activities, the quality of teaching provided by the facilitator, self-confidence in learning, and student responsibility for their own learning. Participants indicate their level of agreement with each item on a five-point scale, ranging from "strongly disagree" to "strongly agree." The closer to 5, the higher the level of satisfaction with learning and self-confidence.
3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Brasilia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 4, 2024

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 1, 2024

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 27, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 15, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 20, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 10, 2024

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 8, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 76082423.1.0000.8093

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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