Anthony Marcellin, Marie-Claude Langevin, and Jean-Philippe Adam
Serious gaming is used for purposes other than entertainment, such as teaching and continuing education, and can help to improve knowledge acquisition and to enhance cognitive or technical skills.1,2 In recent years, escape games have been increasingly exploited for educational purposes, especially in professional settings and university pharmacy programs.3–8 In a university pharmacy program, escape rooms can be used for training second- and third-year students to address various clinical situations (e.g., diseases/conditions such as diabetes, cancer, or heart failure; activities such as nonsterile compounding).6–11 However, to the authors’ knowledge, only 2 studies have evaluated the effects of escape games on hospital pharmacists and pharmacy technicians.12,13
In a fun context, escape games allow for the development of essential team skills such as communication, listening, and leadership. To take advantage of this trend, an escape game was created as a special event for the department of pharmacy of the Centre hospitalier de l’Université de Montréal. The goal of this study was to determine whether the activity had any effect on participants’ knowledge about their colleagues, their happiness at work, their feeling of belonging to the department, and the translation of skills (communication, listening, logic, leadership, deduction, teamwork) from the game to “real life”.
An escape room game was specially created and set up for members of the pharmacy department of a 772-bed academic hospital. A pharmacy student (A.M.) spent a total of 11 hours writing the scenario, creating the puzzles and riddles, setting up the game materials, and preparing some tests to validate the activity. The escape room used classic mechanisms related to this type of game: chests and 3-digit padlocks, a complex success code, an ultraviolet lamp, and objects to be inserted into specially designed supports.
The game was divided into 5 parts: arrival of participants and determination of the game objective (to open the nurse’s coded computer session in final part of the game); solving the first puzzle to open chest 1; placing petri dishes to open a second room; deciphering symbols (runes and numbers) in a fictitious patient’s file to open chest 2; and collecting the 15 pieces of the final puzzle and solving it to get out of the second room (for more detail, see Table 1). The game included elements related to infectious diseases and cardiology to provide a context like that of a hospital. However, the observation and logic challenges were not intended for participants to acquire knowledge about these clinical topics.
TABLE 1 Parts and Activities of the Escape Game
In teams of 4, the participants had to solve a series of riddles related to a fictitious medical case within a 25-minute period after a short briefing. Each team was allowed to receive up to 3 clues. The pharmacy student supervised the event for a total of 8.25 hours; supervision consisted of preparing for and monitoring each game and resetting the game rooms after completion of each game. The escape room events took place in the morning or afternoon over a period of 3 days in February 2020. After the activity, participants were asked to complete a written 6-question survey (Table 2).
TABLE 2 Results of Questionnaire Distributed to Participants
A total of 51 people participated in the escape room game, representing 20% of the 258 members of the department (pharmacists, technicians, and administrative staff, as well as residents and students). Responses to the questionnaire are shown in Table 2.
The activity was appreciated by all participants, with a mean global appreciation rating of 9.34 on a scale of 1 to 10. All participants stated that they would retry an activity like this at work. The 25-minute escape room experience resulted in a moderate increase in happiness at work and a feeling of belonging to the pharmacy department (reported by 86% and 73% of participants, respectively). Two-thirds (67%) of the participants felt they knew their coworkers better after the escape room game. More than 40% of the players believed they would transfer skills used during the game to their work. Communication, listening, and logic were the 3 skills most likely to be transferred into professional life (reported by 33%, 24%, and 27% of participants, respectively).
Over the past decade, escape room games have become more popular for educational purposes in health care, and they have been adapted for undergraduate students in several health care disciplines, such as pharmacy, nursing, and medicine.1,14 Outside this context, escape room games are rarely used in health care or professional settings such as hospitals.15 To the authors’ knowledge, this study is the third to describe an escape room exercise involving a population of pharmacists, technicians, and administrative staff in a professional pharmacy environment. Given the heterogeneous population, the objective of this activity was slightly different from escape rooms in educational settings and did not include the transmission of knowledge. The collegial and entertainment nature of the escape room allows employees to build motivation and engagement while developing teamwork and communication.14 These activities have been proposed by some private employers for team building among their workers.
In this context, the escape room was offered during work hours to members of our department and students. The activity led to a moderate increase in happiness at work and a feeling of belonging to the pharmacy department for about three-quarters of participants. These 2 factors are important for employee retention, even more so in a pandemic context. Happiness at work affects not only the engagement and satisfaction of individual staff members, but also the patient experience, quality of care, patient safety, and organizational performance.16
In the pharmacy department of an academic centre, an escape room game had a positive impact on participants’ knowledge of their coworkers, their happiness at work, their feeling of belonging to the department, and the translation of skills. To our knowledge, this is the first study to show increases in level of happiness at work and the feeling of belonging after participation in an escape room game.
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Competing interests: None declared.
Funding: None received.
Canadian Journal of Hospital Pharmacy, VOLUME 76, NUMBER 3, Summer 2023