The Effect of Escape Room Simulation on Nursing Students' Knowledge and Academic Self-Efficacy Regarding Stoma Care: A Randomized Controlled Study

Stoma is a crucial surgical procedure used to treat digestive or urinary system diseases, facilitating passage for stool and urine, promoting wound healing, and reducing complications. In the US, it is reported that approximately 750,000-1 million people live with stomas, and around 100,000 new stoma surgeries are performed annually. Therefore, nurses assume critical responsibility in stoma care through education, counseling, direct care, and complication management. However, the International Ostomy Guidelines (2020) reveal a lack of knowledge and experience among both clinical nurses and nursing students. Similarly, Zimnicki and Pieper (2018) noted that students have low levels of knowledge and insufficient self-confidence in practicing stoma care. Therefore, it is inevitable that stoma care becomes a fundamental component of the nursing curriculum. Students learn these skills through theoretical training, demonstration methods, and psychomotor skill applications; effective and high-quality training reduces anxiety in clinical practice, increases self-confidence, and facilitates the transition to a professional role. Nurses are responsible for providing safe care by making critical decisions in increasingly complex clinical settings. Therefore, nursing education programs must equip students with the skills to integrate current theoretical knowledge with fundamental practical skills, target behaviors, and professional attitudes. The literature shows that innovative learning methods significantly improve students' exam success and conceptual learning levels compared to traditional approaches; they also strengthen motivation, satisfaction, participation, and interaction. These methods also support self-confidence, communication, and critical thinking skills; and contribute to the more effective application of basic nursing skills by integrating them with theoretical knowledge. Innovative learning methods in nursing education include problem-based learning, collaborative learning, game-based learning, simulation-based learning, case-based learning, web-based learning, and concept maps. Escape room simulations, which combine these methods, have emerged as a remarkable innovation in nursing education in recent years. It has been observed that escape room applications improve students' clinical decision-making, communication, teamwork, and problem-solving skills, and studies on this topic are rapidly increasing in the literature. No studies have been found in the literature examining the application of escape room simulation for stoma care on nursing students. Therefore, it is predicted that escape room simulation will increase nursing students' knowledge levels and academic self-efficacy regarding stoma care.

This research was planned to determine the effect of escape room simulation on nursing students' knowledge and academic self-efficacy levels regarding stoma care.

Materials and Methods Study Design The research was planned as a randomized controlled trial with a pre-test-post-test-follow-up design with experimental and control groups.

Research Hypotheses H1: Escape room simulation increases nursing students' knowledge levels regarding stoma care.

H2: Escape room simulation increases nursing students' academic self-efficacy regarding stoma care.