The Effect of Escape Room-Based Elimination Training on Student Outcomes

The Effect of Escape Room Games Used in Elimination Care Training on Nursing Students' Levels of Knowledge, Skills, Motivation, and Satisfaction

This clinical trial aims to find out if playing an "educational escape room" game helps nursing students better learn how to manage patient elimination (urinary and bowel care). The study looks at how this game affects students' knowledge, hands-on skills, their desire to learn (motivation), and how happy they are with the training (satisfaction).

The main questions the researchers want to answer are:

Does the escape room game help students understand the rules and steps of elimination care better than traditional lessons?

Does this method improve students' practical skills in tasks like inserting catheters, giving enemas, and performing stoma care?

How does the game affect students' motivation to learn and their overall satisfaction with the nursing program?

Researchers will compare students who use the educational escape room with students who learn through traditional methods to see if the game makes a real difference in their performance.

Participants in this study will:

Learn the theory behind bowel and bladder care (such as enemas and catheterization).

Work in small groups to solve puzzles and find clues inside a themed room to complete patient care tasks.

Take knowledge tests and practical "skill exams" after the training.

Fill out surveys about how motivated they felt and how much they enjoyed the learning experience.

Study Overview

• Status: Not yet recruiting
• Conditions: Student Education
• Intervention / Treatment: Other: Educational Escape Room on Elimination Care

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: HANIM DURU YÜCE BAŞARAN, PHD CANDIDATE; Phone Number: +905383360476; Email: duruycbsrn@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Being a second-year student enrolled in the Nursing Department.
• Taking the Nursing Fundamentals course for the first time.
• Not having previously received practical training or experience in an "Educational Escape Room."
• Volunteering to participate in the study and providing written informed consent.
• Being available to attend all training sessions (both theoretical and practical) during the study period.

Exclusion Criteria:

• Students who are repeating the Nursing Fundamentals course.
• Students who have transferred from another nursing program and have already completed elimination care training.
• Students with physical disabilities or health conditions that prevent them from participating in the physical activities of the escape room.
• Students who have professional experience as a nurse or health technician (e.g., those who graduated from vocational health high schools and worked in the field).
• Students who do not complete the initial theoretical training or miss the pre-test assessments.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Educational Escape Room Group	Other: Educational Escape Room on Elimination Care; This intervention utilizes a gamified, time-bound, and scenario-based "Educational Escape Room" specifically designed for nursing education on elimination procedures. Unlike traditional laboratory demonstrations, students are placed in a simulated clinical environment where they must solve sequential cognitive puzzles and correctly perform psychomotor skills-such as urinary catheterization and enema administration-to "unlock" the next step and escape the room. This method transforms passive learning into an active, high-engagement experience that requires immediate application of theoretical knowledge, critical thinking, and teamwork under a structured time limit, making it distinct from standard observational or practice-based laboratory sessions.
No Intervention: Traditional Laboratory Training Group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychomotor Skill Scores on Elimination Procedures	This measure represents the students' proficiency in performing urinary catheterization, enema administration, and stoma care. Skills are assessed using "Elimination Procedure Skill Checklists" validated by expert opinion. Each step of the procedure is scored as "Completely Performed (2 points)", "Incompletely Performed (1 point)", or "Not Performed (0 points)". Higher total scores indicate a higher level of clinical psychomotor competence in performing the tasks.	4 WEEK
Psychomotor skill performance levels of nursing students regarding elimination procedures (assessed via standardized skill checklists).	This measure represents the students' proficiency in performing urinary catheterization, enema administration, and stoma care. Skills are assessed using "Elimination Procedure Skill Checklists" validated by expert opinion. Each step of the procedure is scored as "Completely Performed (2 points)", "Incompletely Performed (1 point)", or "Not Performed (0 points)". Higher total scores indicate a higher level of clinical psychomotor competence in performing the tasks	4 WEEK

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge Scores on Elimination Procedures	The level of theoretical knowledge regarding urinary and bowel care, measured using a multiple-choice "Elimination Procedures Knowledge Test" developed by the researchers. Higher scores indicate a better understanding of the theoretical concepts.	4 WEEK
Learning Motivation Scores	Students' motivation levels towards the learning process, assessed using the "Instructional Materials Motivation Scale (IMMS)". The scale measures attention, relevance, confidence, and satisfaction.	4 WEEK

Collaborators and Investigators

• Sponsor: Ataturk University

Publications and helpful links

General Publications

• Akpolat, R., Terzioğlu, F., Yüksel, A., & Özdemir, T. (2025). The Effect of Escape Room Teaching Method on Nursing Students' Knowledge and Motivation in the Evaluation of Enhanced Recovery After Surgery Protocol: Cross-Sectional and Interventional Research. Turkiye Klinikleri Journal of Nursing Sciences, 17(3), 677-684.
• Akatsu, H., Shiima, Y., Gomi, H., Hegab, A. E., Kobayashi, G., Naka, T., & Ogino, M. (2022). Teaching "medical interview and physical examination" from the very beginning of medical school and using "escape rooms" during the final assessment: achievements and educational impact in Japan. BMC Medical Education, 22(1), 67.

Study record dates

Study Major Dates

• Study Start (Estimated): April 27, 2026
• Primary Completion (Estimated): May 27, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: April 24, 2026
• First Submitted That Met QC Criteria: April 24, 2026
• First Posted (Actual): May 1, 2026

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 24, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: NURSING; EDUCATION; ESCAPE ROOM
• Other Study ID Numbers: ATA_NURSE_DY_01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The individual participant data (IPD) collected during this study will not be shared with third parties or other researchers. This decision is made to protect the privacy and anonymity of the nursing students who participated in the research. The data will only be used for the purposes of this doctoral thesis and related academic publications in an aggregated format, ensuring that no individual student can be identified.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No