Improving Pediatric Nursing Undergraduate Education: An Escape Room on Dehydration in Children

Pediatric nursing education aims to train nurses who can respond safely and effectively to the complex and rapidly changing healthcare needs of children. Accordingly, nursing students are expected to possess not only theoretical knowledge but also clinical reasoning, rapid decision-making, effective communication, teamwork, and psychomotor skills. Therefore, it is recommended that undergraduate nursing education be supported by active and student-centered learning approaches that develop students' critical thinking, problem-solving, clinical decision-making, and teamwork skills. While traditional teaching methods are effective in transferring basic knowledge, they may be limited in developing students' ability to integrate and utilize their clinical knowledge and skills. In contrast, active learning approaches are reported to increase knowledge transfer, clinical performance, and learning retention.Game-based learning, which is among the active learning methods, has been widely used in nursing education in recent years. Process, is reported to increase student participation and motivation in learning, support critical thinking, problem-solving, and knowledge retention, and reduce anxiety related to learning. Furthermore, game-based learning contributes to the development of professional skills necessary for pediatric care, such as communication, leadership, and teamwork.

Educational escape rooms, one of the innovative applications of game-based learning, are a student-centered teaching approach that integrates gamification principles with problem-solving-based learning. In these applications, structured around realistic clinical scenarios, students complete tasks as a team by analyzing clinical clues within a specific time frame; during this process, they simultaneously use communication, clinical reasoning, and decision-making skills. Structured feedback sessions allow students to evaluate their experiences and reinforce their learning.

Recent studies have shown that educational escape rooms have positive effects on nursing students' knowledge level, clinical reasoning, teamwork, and learning satisfaction. Systematic reviews also reveal that this method facilitates the transfer of theoretical knowledge to clinical practice and improves problem-solving and clinical decision-making skills. Although educational escape rooms have been implemented in various nursing fields such as women's health, child health, geriatrics, cardiovascular care, clinical skills, teamwork, and leadership, evidence regarding applications focusing on dehydration management in children is quite limited. Dehydration is a common and significant clinical problem in childhood that can lead to serious morbidity and mortality if not managed properly (source). Therefore, nurses need to have sufficient knowledge and skills to recognize early signs of dehydration, assess the degree of fluid loss, and plan appropriate nursing interventions. However, nursing students have limited opportunities for clinical experience to develop these skills. The literature lacks a study that develops and evaluates the effectiveness of an educational escape room application focusing on the assessment and management of dehydration in children for nursing students. This study, planned to address this research gap, aims to evaluate the effect of an educational escape room, developed within the scope of pediatric nursing laboratory practice, on nursing students' hydration knowledge level, teamwork, and situational anxiety levels.