ARCS-Based Escape Room Education and Medication Skills in Nursing Students

This randomized controlled trial aims to evaluate the effect of an ARCS-based escape room educational intervention on nursing students' medication administration knowledge, clinical skills, and learning motivation. Medication administration errors represent a major threat to patient safety, and nursing students must develop safe medication practices early in their education through effective and engaging instructional approaches. The study will be conducted with first-year undergraduate nursing students enrolled in a Fundamentals of Nursing course at a public university. Participants will be randomly assigned to either an intervention group or a control group. Both groups will receive standard theoretical instruction and laboratory-based training on medication administration. In addition, the intervention group will participate in an ARCS-based escape room activity designed to reinforce medication administration competencies. The escape room intervention will be structured according to Keller's ARCS Motivation Model (Attention, Relevance, Confidence, Satisfaction) and will include scenario-based learning stations focusing on oral medication administration and parenteral medication administration operationalized as subcutaneous and intravenous routes. Each station will require students to apply medication safety principles, clinical decision-making, and procedural skills within a time-limited, team-based game environment. Primary outcomes will include medication administration knowledge and clinical skill performance assessed using a structured knowledge test and objective structured clinical examination (OSCE). Learning motivation will be evaluated as a secondary outcome using a validated motivation scale based on the ARCS model. Assessments will be conducted at baseline and after completion of the educational intervention. The findings of this study are expected to provide evidence regarding the effectiveness of ARCS-based escape room education as an innovative