Digital Escape Room Game for Hypovolemic Shock Management

Background: Digital escape room games have emerged as innovative pedagogical tools in nursing education, providing immersive and engaging learning experiences. Although their use has expanded to various topics, little is known about their impact in teaching the management of life-threatening emergencies such as hypovolemic shock. Aim: To evaluate the effects of a digital escape room game on nursing students' knowledge, satisfaction, and perceptions of hypovolemic shock management. Methods: An explanatory sequential mixed-methods design was employed. In the quantitative phase, a randomized controlled trial was conducted with 55 third-year nursing students assigned to an intervention group (digital escape room) or a control group (traditional lecture). Knowledge levels were assessed at three time points, and the GAMEX scale measured game experiences. In the qualitative phase, focus group interviews were conducted with 12 students from the intervention group to explore experiences in greater depth. Quantitative data were analyzed using repeated-measures ANOVA, and qualitative data were analyzed thematically. Results: Quantitative findings revealed no statistically significant differences in knowledge scores between the groups over time. However, students in the intervention group reported high levels of enjoyment, motivation, and creative thinking. Qualitative results indicated that the digital escape room reinforced theoretical knowledge, promoted reflection on knowledge gaps, and enhanced critical thinking, problem-solving, and clinical decision-making. Students also emphasized that the game simulated the pressure of real clinical environments, enabling them to practice rapid responses in a safe, engaging context. Conclusion: Although no significant improvements in knowledge scores were detected, the digital escape room offered substantial educational benefits by strengthening motivation, engagement, and higher-level competencies. It may serve as an innovative co