Kelly Casler, DNP, APRN-CNP

Assistant Professor of Clinical Practice, Family Nurse Practitioner
College of Nursing


Escape Rooms to Support Clinical Decision-Making

Courses Taught:

  • N7268.01, N7268.02, and N7268.03: Family Nurse Practitioner Clinical Course Work
  • N7450 Advanced Health Assessment, Advanced Pathophysiolog
  • N8897 Doctor of Nursing Practice Inquiry II


Escape Room Course:

  • N7268.03: Health Promotion and Screening Module


Assistant Professor Kelly Casler came up with the idea to create a virtual escape room while watching her colleague  Assistant Professor of Clinical Nursing Amy Mackos implement one in a face-to-face pathophysiology class during the autumn semester. 

She made preliminary plans and then “got busy and [the assignment] got put on the back burner.” Then, the COVID-19 response heightened the need for students to practice clinical reasoning without the luxury of actually being in clinicals. 

In Casler’s Health Promotion Escape Rooms activity, students are presented with theoretical patients visiting a busy primary care clinic. Based on patient age and health information, as well as past medical, family and social history, students work in teams and against the clock to unlock immunization, laboratory, screening tests, and counseling escape rooms, moving from one correct assessment to another. The activity takes place on Google sites, and healthy competition (pun intended) is encouraged. Teams take between 20 and 40 minutes to fully “escape” or complete all of the problems. 

One activity begins, “Due to the coronavirus, the NCAA has scheduled an abbreviated 2020 football season. There are only four games, and each game is only one quarter in length. Your task today is to beat your four opponents by providing health promotion decisions and counseling for … our patient below.” The games happen to feature Michigan State, Penn State, University of Michigan and Alabama. 

Student response to the escape room activity has been positive, Casler said. They have particularly appreciated an “Are you stumped?” prompt that allows them to examine the rationale for selecting particular immunizations, tests and health counseling.  

“In reality, in the clinical practice setting, the electronic ordering system will (provide them with) a larger list of tests and ask which of these they want to order, similar to how they have to select from the list I gave them to figure out the escape code” Casler said. “They will see this type of decision making in practice.”

Casler designed her cases so that they might be used by other faculty  in the nurse practitioner program, which includes family, pediatric, women’s health and adult specialties. 

“I tried to build it so that as many faculty as possible could share them and so that one teaching tool could apply to as many classes and students as possible,” she said.  

This type of efficiency and “working smarter, not harder” only benefits students, she added.  

Prof. Casler also values co-teaching and “just sitting back and watching my colleagues to pick up tricks and tips by watching their approach to teaching.”

She said coming to Ohio State has helped her grow as a faculty member. At the College of Nursing, in particular, there’s support for trying new things. She noted that Joni Tornwall, PhD and RN who co-directs the college’s Academy for Teaching Innovation, Excellence and Scholarship, is always there to help from an educational technology standpoint as she did with this project. 

“And if you fail, you fix it and try again,” she said.  

For more information on using escape rooms to facilitate active learning, read this article from the Journal for Nurses in Professional Development.