Playful experience, learning perception, and motivation in a cooperative escape room activity in undergraduate nursing education: A mixed-methods study

Escape rooms are an innovative pedagogical approach based on problem-solving and focused on the student's autonomous learning competencies to resolve a realistic or fictitious situation. Assessment of students' perception of their own learning and motivation with this approach, and the qualitative description of escape rooms is limited. To evaluate the gameful experience, learning perception, and motivation in cooperative learning among students participating in an escape room. All sophomore nursing students enrolled in the subject ‘History, Theory and Methods of Nursing II’. A sequential explanatory mixed-methods design was employed. Quantitative data were collected through Gameful Experience Scale (GAMEX) and Cooperative Playful Learning Strategies (CMELAC) after the escape room activity. The qualitative phase involved thematic analysis of interviews to explore students' perceptions of the activity. Quantitative analysis revealed high enjoyment (4.64 ± 0.62 out of 6 points) and activation (4.34 ± 0.87 out of 6 points) scores, with significant correlations between GAMEX and CMELAC total scores (r = 0.566, p < 0.001). Qualitative themes highlighted camaraderie, fun, and applicability of learning as positive aspects, while limited resources and negative competitiveness were noted challenges. Integrated data showed that high GAMEX scores correlated with positive qualitative experiences. The escape room activity was an effective educational tool, enhancing engagement, teamwork, and application of nursing concepts. While resource constraints and competitive elements posed challenges, the activity supported meaningful learning and active participation. This study underscores the potential of gamified strategies in nursing education, recommending further research on scalable adaptations and robust assessment of learning outcomes. • Escape rooms improve engagement, teamwork and creative thinking in nursing students. • Gameful Experience Scale and Cooperative Playful Learning Strategies scores correlated. • Nursing students valued camaraderie, fun and real-world applicability of learning. • Resource limitations and competitiveness were noted as challenges.