Preparing future nurses requires more than memorization. It demands critical thinking, teamwork and the ability to apply knowledge in fast-moving, realistic situations. At the University of Nevada, Reno’s Orvis School of Nursing, Professor Hannah Winder, lecturer II, is helping students build those skills through an innovative approach: virtual escape rooms.

Winder has developed a series of interactive, themed experiences that challenge students to solve puzzles, apply nursing concepts and collaborate as they work toward a common goal. These activities are integrated across both didactic and clinical settings, including NURS 331: Pathophysiology and Pharmacology, as well as other upper-level clinical courses.

“Students find them educational and fun,” Winder said. “There’s a little bit of competition, but overall, it’s a low-stakes way to practice critical thinking and apply what they’ve learned.”

The virtual escape rooms mirror the structure of an in-person experience. Students enter a themed website with a storyline and instructions, then explore clickable elements that reveal puzzles. Each correctly solved challenge unlocks a code, number or clue that advances them to the next step.

The final task requires students to combine all collected clues to unlock an exit code or decipher a message. Successful completion leads to a final “congratulations” screen, signaling the end of the experience.

Winder updates the puzzles each semester to reflect cohort needs, ensuring alignment with course objectives and clinical experiences. 

In addition to clinical applications, the escape rooms serve as exam review tools. Students revisit key concepts as they work through challenges that emphasize application over memorization, particularly in the lead-up to exams in pathophysiology and pharmacology.

One of the most widely used modules is a Level 4 critical care escape room designed for senior nursing students. The activity emphasizes complex decision-making, prioritization and teamwork under time-sensitive conditions.

The approach has also expanded into simulation-aligned learning strategies across the program, reinforcing skills students later apply in high-fidelity simulation and clinical practice.

Haley McNeil, director of simulation at the Orvis School of Nursing, supports integrating active learning strategies that complement simulation-based education.

“At Orvis School of Nursing, we use gamification to create learning experiences that are active, collaborative and fun," McNeil remarked. "One example is an in-person interprofessional escape room we developed with nurse practitioner and physician assistant students. Learners had to work together to solve clinical problems, communicate clearly and apply their knowledge in a low-risk environment.

"We also use similar principles in other activities, like unfolding patient scenarios, deliberate practice stations and team-based simulation experiences, where students are challenged to clinically reason, experiment with previously learned skills and reflect on their actions.”

Winder’s work is also gaining attention beyond campus. She will present the model at the Nurse Educator Conference in the Rockies in June alongside Professor Jasen Brooks, lecturer II, and Amanda Lee of San Joaquin Delta College. Their session will include a how-to guide and a pre-built Canva template to help nurse educators create their own escape room activities.

“As educators, we are always looking for ways to engage students and help them connect knowledge to practice,” Winder said. “These escape rooms give students an opportunity to work through concepts together in a way that is both challenging and enjoyable.”

By blending technology, simulation-informed teaching and collaborative problem-solving, virtual escape rooms offer students a creative pathway to strengthen clinical reasoning and confidence before entering practice. This approach reflects the University’s commitment to The Wolf Pack Way through innovation, teamwork and student-centered learning.