An escape game concept for the preparation of medications in clinical trials in the sterile sector : a playful and useful training course

M. Saglio1 , C. Gervaise1, S. Emery1, V. Breant1 1 : Hospices civils de Lyon, Pharmacie à usage intérieur, Groupement hospitalier Est
59 Boulevard Pinel 69500 Bron FRANCE


The preparation of injectable medications in clinical trials (CT) requires a sterile environment. The objective of this project was to set up a playful, simulation-based evaluation such as an "escape game" for the hospital pharmacy staff who have to prepare CT medicines in a sterile environment.

A fake study was created, as well as a fake prescription and a fake manufacturing sheet. The player, accompanied by an examiner, must first find the errors inserted on a prescription in order to gain access to the key to enter the sterile environment. The player must then find the dress code errors on the manipulator in order to open the padlock of the equipment store. Then, the player must choose the materials needed for the fabrication of the medicine, which enables him or her to free the manipulator. Finally, while the manipulator carries out the preparation, the player must find the handling errors in order to open the last padlock. Finally, each player is asked several questions about the situation regarding problems like a broken bottle, accidental exposure to blood, and loss of a product. A self-assessment and satisfaction questionnaire are completed by the player before and after the game.

11 participants tested the game (3 pharmacists, 2 residents, 3 pharmacy students and 3 technicians). All participants had previous experience with preparation of CT medicine. The average duration of the game was 41min27.On average, in response to the question "Do you feel comfortable with sterile environment preparation ?", participants’ responses increased by 0.4 out of 5 points after the completion of the game. The difficulty of the game was rated at 2.6/5 and its usefulness at 4.8/5. In response to the question about the extent to which they felt stuck in the steps of the game, the average response of the participants was 3.4/5. On average, students needed help 8 times, preparers 5 times, interns 7 times, and pharmacists 6 times. 10/11 of the participants were very satisfied and 1/11 somewhat satisfied. The duration of the game was suitable for all participants. The average response to the quiz was 4.4/5.

This training method was very much appreciated by the participants, whether they were experienced players (preparers, pharmacists) or more novice players (residents, students). The real-life simulation and the "escape game" concept had a positive impact on improving professional practices. This game was able to highlight the evolution of each participant and allowed them to question certain bad preparation practices. The real-life simulation with a fake manipulator allowed the participants to be trained on mistakes that must not be made in the sterile environment. This evaluation will be applied to the staff who are required to handle or double-check clinical trial preparations after theoretical and practical training.

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