“Save Patient B”. An Escape Game in a Cytotoxic Production Unit"

Objective:
Following an internal audit which highlighted deviations from procedures and an analysis of errors made within the Cytotoxic Production Unit (CPU), it was decided to use a serious game to strengthen ongoing training. The aim of this project was to design and test an immersive educational escape game (EG) for the CPU staff.

Method:
A scenario was drawn up by a working group comprising two residents, two pharmacy technicians and a pharmacist. The activity, carried out in pairs, began with an introductory and immersive briefing, followed by eight blocking chronological puzzles leading to the preparation of two fictional chemotherapy bags. The puzzles focused on the compliance with entry rules in cleanroom, the knowledge of chemotherapy protocols, the mastery of double control in production, and the management of reallocations. Two non-blocking errors were present within the EG, allowing participants to earn bonuses or penalties. The time taken and whether or not to use a hint were recorded to assess autonomy and fluidity of reasoning. An evaluation by the participants was carried out. The evaluation, using a 4-point Likert scale, focused on the overall satisfaction with participating in the EG, stress, learning, relevance, knowledge reactivation, as well as the difficulty and the duration of the EG. A debriefing on key points closed each session.

Results:
Two pairs of pharmacy technicians and three pairs of pharmacists/residents completed the EG with an average completion time of 44 minutes [40-50]. All puzzles were solved, with all pairs requiring hints. In addition to the puzzles, one pair detected both hidden errors and three pairs detected one. Regarding participant satisfaction, all participants enjoyed the training (3.9/4) and reported little or no stress (1.7/4). Participants felt that the EG enabled them to reactivate knowledge (3.2/4), that the exercise was relevant (3.6/4), and that it enabled them to maintain their knowledge over the long term (3.3/4). According to participants, the difficulty level and duration of the EG were appropriate, with ratings of 3.4/4 and 3.8/4 respectively.

Discussion / Conclusion:
The setting up of an EG within the CPU was appreciated and, according to the participants, enabled them to consolidate their knowledge. The debriefing time was particularly enriching for the whole team, and triggered many questions to be addressed. The longer-term objective is to continue this type of edutainment training by creating new scenarios.

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