(1113) An Escape Room Activity for Evaluation of a Transformative Learning Safety Science Curriculum

Introduction: Escape rooms can be used to teach and practice a skill set, and test affective and behavioral change within a group. We describe the use of an escape room as evaluation of a transformative learning safety curriculum aimed to inculcate the Just Culture and Safety Differently mindset in trainees. Safety Differently encourages organizations to learn from people within, improve work conditions to better align with organizational goals and support processes that result in successful outcomes. We utilized escape room as an engaging modality to recall and practice key cognitive, behavioral and affective components of Safety Differently.

Methods: We designed a case-based escape room activity for pediatric critical care medicine fellows at Texas Children’s Hospital. We engaged experts in medical education with experience in serious game and escape room development. We ran a simulated escape room with volunteer faculty to ensure technical details matched our expectations.

Results: Twelve fellows, divided into three teams, participated in the activity. After a pre-brief, the teams set forth to sequentially solve four puzzles and open a series of locks to successfully escape in 30 minutes. The first three puzzles were a letter scramble, crossword with key in invisible ink, and matching prompts with directional clues. Collaboration between teams occurred to solve the matching prompts as three simultaneous locks needed to be opened to proceed. The final task required conversation between the teams and a moderator to deliver a puzzle to open the last lock. Each team utilized the Safety Differently concepts of asking better questions, teamwork, and assessment of context to move through the series of activities.
In a 15-minute structured interview immediately following the activity, the fellows welcomed the engaging and creative modality of the escape room set up, appreciated different perspectives relevant to their clinical duties, and enjoyed applying concepts and problem solving as a team. All fellows strongly agreed the patient scenario was relevant to their practice and tested their ability to understand context and learn the safety event through better questions.

Conclusions: Escape room exercises can strengthen recall and encourage application of key components of the Safety Differently mindset.