When Illinois Wesleyan University nursing students Angel Lee, Davion Lemon and Jovan Perez showed up to take part in a mandatory escape room assignment Wednesday afternoon, they didn’t know what to expect.
The Junior students in the School of Nursing and Health Sciences were told it would be a fun exercise that would go toward their clinical hours. Those were about all the details they got.
It would be no ordinary escape room. This was a mental health escape room, placed in the nursing school basement where students normally do simulations — organized hospital scenarios to test their knowledge.
Just before they entered the room, simulation coordinator Amanda Kemp finally explained the rules.
“It’s meant to be a game,” she said. “Obviously, there’s a little competition to it. I will time you.”
Each student group is given 30 minutes to complete the exercise. Kemp provides only enough detail for students to get their bearings. She can’t say too much because it could spoil the surprise.
They can use anything in the room to find the clues that leads to an IWU ID badge. This is their key out of the room.
Kemp watches from a one-way mirror in the room next door., and provides two clues in total. A second clue will increase their final time.
One thing she makes clear: this is not like their normal exercises.
“It’s definitely when you go in there an escape room,” she said. “The patient’s not gonna talk to you. It’s only puzzles and clues once you’re in there.”
Her parting words are “there is an overarching theme,” and if they play the game right, they will realize what it is halfway through.
Once Lee, Lemon and Perez are inside, they are faced with a traditional hospital room. All the typical fixtures are there, including a “patient” — actually a mannequin — on the hospital bed.
It's all meant to simulate a real psychiatric nursing ward.
The students go straight to the food tray to read the provided information about their patient. Then they begin checking "him" for any items that "he" should not have.
All Lee finds is a piece of a rubber band and a finger-size blue light. She tries shining it on the patient and other items, but has no luck reading encrypted messages.
What went wrong
It would be several minutes before the students find a weapon hidden in the patient’s sock, which would be the first domino in solving the puzzle.
Lily Summers, a senior nursing student and one of the people who helped design the escape room, explained how it should have gone down.
“For mental health nursing, you're supposed to walk in and identify your dangers to the patient right away,” she said. “So this is a new patient. So we're supposed to come in and do our full skin checks.”
She said this is when students were supposed to find the pocket knife that had a flash drive attached to it: a major clue.
“Then you're also supposed to recognize that you're not allowed to have any types of sharps,” she said, referring to sharp objects. “So the glass plate, and then all of the silverware. You're supposed to be able to like flip that over and see that the clue on the backward says like the ‘labs equal the lock.’ Those are supposed to be like your big red flags.”
This clue was on the underside of the fork that Kemp said after the game many students overlook. They go immediately for the plate and the knife, forgetting that a fork is also a potential danger.
The note, “labs equals lock” indicates they should look at the patient information to get the code for a combination lock. This lock will release a key that gets them into the drawer where the ID badge is located.
After that, they get out.
“We need to make sure our patients are as safe as possible to themselves and to us as nurses and to everyone else on the unit,” Summers said. “That’s the biggest part about mental health nursing.”
It took Lee, Lemon and Perez around 18 minutes to “escape.” They got three additional minutes tacked onto their final time because they used two clues. This put them in second place, but there were a few more groups scheduled after them.
Learning outcomes
While it was a game, Kemp said it forced the students to go through the motions of patient care in a way that was different from a simulation.
“All they have are the puzzles to help them meet the learning objectives, versus in a simulation they have what the patient's telling them, what they're getting out of the assessment skills, what they're actually doing as far as assessment skills to get those learning objectives met,” she said.
But the students said they learned something.
Perez said it taught him to “think outside the box.”
“For example, like looking inside the patient's mouth, like maybe that might not be something that we usually think to do, but I guess in the escape room, we kind of had to,” he said, referring to a clue they were told about after the game. “So we just had to think differently.”
Lee said this clue was a learning point for her, too.
“We know the six rights of medication, but prior to junior year, it would be like, ‘right, route? Oh, okay, it's your mouth,’” she said, referring to the final right of medication: check the right route. “Not, ‘I'm gonna open your mouth and check.’”
There also will be a debrief once all of the students complete the escape room, Kemp said, as a continuation of the lesson.
Making nursing fun
In addition to putting students through an innovative brain teaser, associate professor Wendy Kooken said part of the goal was to have a good time.
“My age-old question is can nursing school be rigorous and fun?” she said, adding this helped solve that riddle.
“We're trying to do some things that provide some kind of release a little bit, and not so much about passing or failing,” she said.
The staff got to have some fun, too. Remember the blue light that Lee found during the simulation? It wasn't put there by mistake. Kemp had written a hidden message on the ceiling: "Ha ha I tricked you."
IWU will be presenting about the mental health escape room at an upcoming conference.
