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Background <p>High-quality cardiopulmonary resuscitation (CPR) depends not only on technical competence but also on effective communication, role clarity, leadership, and coordinated team performance under pressure. However, conventional CPR instruction may not adequately reproduce the collaborative and time-sensitive demands of real resuscitation. Educational escape rooms (EERs), as simulation-based gamified learning strategies, may provide a more immersive and learner-centered approach to strengthening both cognitive and teamwork-related aspects of CPR training. This study protocol was developed to evaluate the effect of a team-based CPR educational escape room (CPR-EER) integrated into advanced life support (ALS) training for undergraduate nursing students.</p> Methods <p>This study was designed as a two-arm, parallel-group, assessor-blinded randomized controlled trial with a 1:1 allocation ratio. Participants were seventh-semester undergraduate nursing students at Shahid Sadoughi University of Medical Sciences, Yazd, Iran. All participants first received a standardized 8-hour CPR refresher workshop to establish a common educational baseline. The intervention group then participated in a structured CPR-EER delivered in fixed six-member teams in a simulated in-hospital cardiac arrest environment, whereas the control group continued with the routine curriculum during the primary comparison phase and received the intervention after post-test assessment. The primary outcome was team coordination during CPR, assessed using a Team Objective Structured Clinical Examination (TOSCE). Secondary outcomes included role-specific performance, CPR knowledge, and learner satisfaction. Outcomes were assessed at baseline and one month after the intervention. Data analysis was prespecified using a per-protocol framework and distribution-appropriate statistical tests.</p> Discussion <p>This protocol provides a methodologically explicit and pedagogically grounded model for evaluating a gamified, team-based CPR-EER training strategy in undergraduate nursing education. By aligning intervention design, educational objectives, and outcome assessment, it may contribute to the development of more immersive, competency-oriented, and reproducible approaches to resuscitation training.</p> Trial registration <p>Iranian Registry of Clinical Trials (IRCT), registered on 16 October 2024, IRCT20240815062770N1. Available at: <a href="https://irct.behdasht.gov.ir/">https://irct.behdasht.gov.ir/</a>.</p>

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Design and protocol of a randomized assessor-blinded controlled trial evaluating an educational escape room for individual and team cardiopulmonary resuscitation skills among nursing students

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Fatemeh Bakhshi,
  • Amir Dehghani Ashkezari,
  • Sara Heydari

摘要

Background

High-quality cardiopulmonary resuscitation (CPR) depends not only on technical competence but also on effective communication, role clarity, leadership, and coordinated team performance under pressure. However, conventional CPR instruction may not adequately reproduce the collaborative and time-sensitive demands of real resuscitation. Educational escape rooms (EERs), as simulation-based gamified learning strategies, may provide a more immersive and learner-centered approach to strengthening both cognitive and teamwork-related aspects of CPR training. This study protocol was developed to evaluate the effect of a team-based CPR educational escape room (CPR-EER) integrated into advanced life support (ALS) training for undergraduate nursing students.

Methods

This study was designed as a two-arm, parallel-group, assessor-blinded randomized controlled trial with a 1:1 allocation ratio. Participants were seventh-semester undergraduate nursing students at Shahid Sadoughi University of Medical Sciences, Yazd, Iran. All participants first received a standardized 8-hour CPR refresher workshop to establish a common educational baseline. The intervention group then participated in a structured CPR-EER delivered in fixed six-member teams in a simulated in-hospital cardiac arrest environment, whereas the control group continued with the routine curriculum during the primary comparison phase and received the intervention after post-test assessment. The primary outcome was team coordination during CPR, assessed using a Team Objective Structured Clinical Examination (TOSCE). Secondary outcomes included role-specific performance, CPR knowledge, and learner satisfaction. Outcomes were assessed at baseline and one month after the intervention. Data analysis was prespecified using a per-protocol framework and distribution-appropriate statistical tests.

Discussion

This protocol provides a methodologically explicit and pedagogically grounded model for evaluating a gamified, team-based CPR-EER training strategy in undergraduate nursing education. By aligning intervention design, educational objectives, and outcome assessment, it may contribute to the development of more immersive, competency-oriented, and reproducible approaches to resuscitation training.

Trial registration

Iranian Registry of Clinical Trials (IRCT), registered on 16 October 2024, IRCT20240815062770N1. Available at: https://irct.behdasht.gov.ir/.