The « Escape casse »: an educational game on the expected behaviour to adopt when a cytotoxic bottle breaks

J. Touchard1, JS Giraud1, M. Friou1, M. Lafay1, C.Seara1, L. Escalup1 1 Institut Curie - site Saint-Cloud, 35 rue Dailly 92210 Saint-Cloud, France

Introduction
Healthcare professionals’ training through a serious game allows for better learning. Amongst risky situations towards staff and environment, the breakage of a bottle that contains some cytotoxic product remains the most critical incident. An educational escape game about this topic was set depending on good health simulation practices.

Goal
Setting the professional into some realistic environment to have him acquire skills and update his knowledge through an escape game on the expected behaviour to adopt when a cytotoxic bottle breaks.

Method
A workgroup (pharmacists, residents and health manager) created a scenario based on the procedure to follow when a cytotoxic bottle breaks. The playing of the game follows key steps: instructions, setting, critical analysis and evaluation.
The session lasts 30 minutes and is divided into three steps: briefing (5 min), scenario (15 min) and debriefing (10 min). During the timed scenario, a team of three people has to solve four riddles. These ones cover the main steps of the expected behaviour: to warn, protect yourself, get rid of the anticancer agent and decontaminate. By solving the riddles (cloze test, odd one out word elimination…), the team moves forward through the scenario and gets to a debriefing room. During the debriefing, a participant performs a simulation of the expected behaviour in case of bottle breaking, with his team and manager’s help. Finally, they are given a 10-question anonymous satisfaction survey about the game (general opinion, suggested improvements, other topics…).

Results
Six teams (one storekeeper, four pharmacists, 12 pharmacy technicians and one health manager) participated. The mean time to solve the scenario was 14"31[8"23-19"35]. 83% (n=15) of them considered the timing was well adapted. 89% (n=16) of the participants find the process very satisfactory. 78% (n=14) of the participants considered they had updated their knowledge. Half of the participants considered the difficulty level as easy and the other half, relatively easy. Taken as a whole, the four main steps were remembered, but four teams asked for a clue about the safety outfit. They all wanted to repeat the experience with another topic (manipulations under insulators, regulations, traceability, expected behaviour in case of an incident in controlled atmosphere areas…).

Conclusion
The participants were satisfied with this new training model and considered they had some update and a backup of their knowledge. This educational game is a good way to convey and apply strong messages among pharmacy department. Adapting this training model to validate an initial training is being considered.

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