Design, Implementation, and Evaluation of a Virtual Escape Room Exam: A Cross-sectional Interventional Study on Assessing the Learning of Cardiovascular Diseases Among Undergraduate Nursing Students
| Author | Fatemeh Fazlali | en |
| Author | Arghavan Afra | en |
| Author | Noorollah Tahery | en |
| Orcid | Arghavan Afra [0000-0001-8794-1636] | en |
| Orcid | Noorollah Tahery [0000-0002-3205-9483] | en |
| Issued Date | 2025-12-31 | en |
| Abstract | Background: In the digital age, the virtual escape room exam represents an innovative, technology-driven assessment method that integrates gamification with active learning to enhance student engagement, motivation, and critical thinking. As the demand for interactive and student-centered assessment grows, evaluating the educational effectiveness of such game-based models has gained increasing importance. Objectives: This study aimed to investigate the effect of virtual escape room game-based assessment on the learning of cardiovascular diseases (CVDs) among undergraduate nursing students at Abadan University of Medical Sciences. Methods: This cross-sectional interventional study was implemented in six phases: (1) Design of escape room scenarios; (2) validation and reliability testing; (3) pilot implementation; (4) student familiarization; (5) main execution of the escape room exam; and (6) post-exam evaluation and satisfaction assessment. Participants included 62 fifth-semester nursing students in the second semester of the 2024 - 2025 academic year, recruited via census sampling. The escape room consisted of five virtual rooms, each focusing on CVD-related topics. Each room contained five clinical questions, with correct answers unlocking the next level. Students’ scores in the virtual escape room were compared with their performance in an online multiple-choice exam. Data analysis was conducted using SPSS version 26 through descriptive statistics, paired t-test, Wilcoxon signed-rank test, and Pearson’s correlation coefficient. Results: The mean score in the virtual escape room exam (16.93 ± 1.53) was significantly higher than in the multiple-choice exam (15.03 ± 2.52; P = 0.002). A strong positive correlation was observed between the two exams (r = 0.921, P = 0.001). The Difficulty Index was slightly higher for escape room questions (0.914 vs. 0.902). Despite similar difficulty, students performed better in the escape room exam (16.12 ± 1.53 vs. 15.62 ± 1.66). Additionally, 70% - 92% of participants reported high or very high satisfaction with various aspects of the escape room experience. Conclusions: Using an escape room exam to assess the learning of CVDs enhances learning and increases motivation among students. It can also be regarded as a valuable alternative or complement to traditional exams. Therefore, it is recommended that the design and implementation of this type of exam be expanded in educational programs. | en |
| DOI | https://doi.org/10.5812/icrj-166150 | en |
| Keyword | Cardiovascular Diseases | en |
| Keyword | Educational Assessment | en |
| Keyword | Gamification | en |
| Keyword | Nursing Students | en |
| Publisher | Brieflands | en |
| Title | Design, Implementation, and Evaluation of a Virtual Escape Room Exam: A Cross-sectional Interventional Study on Assessing the Learning of Cardiovascular Diseases Among Undergraduate Nursing Students | en |
| Type | Research Article | en |
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