Healthcare simulation is already built around active learning. But even the most carefully designed scenario can become familiar when learners know what to expect: enter the room, assess the patient, respond to the situation and debrief.
What happens when educators change the rules?
Across healthcare education, simulationists are borrowing ideas from escape rooms, role-playing games, interactive fiction and even television game shows to create experiences that ask learners to engage in different ways. The value isn’t simply making simulation more entertaining. Each format introduces a mechanic that can change learner behavior.
Continuing reading to learn about six creative examples.
1. Escape Rooms
Escape rooms replace a straightforward progression through a scenario with puzzles, clues and challenges learners must solve to move forward.
That simple change can alter how learners interact with both the scenario and one another. Instead of waiting for the next piece of information, participants have a reason to actively search, communicate and connect information.
Research into escape-room-based nursing education has associated the format with benefits including engagement, teamwork, problem solving and clinical decision making.
Healthcare educators don’t have to look far for inspiration. In the EMS webinar Innovation in Education: Creating an Escape Room, Wanda Goranson, Simulation Education Manager at UnityPoint Health’s Dorner-Villeneuve Simulation Education Center, discusses how her team created an escape room activity incorporating patient safety, medication error prevention, evidence-based practice and peer review.
The mechanic: Discovery
Learners aren’t simply given information, they have to find, interpret and use it.
2. Murder Mysteries
What if a clinical case were structured more like a mystery? Researchers have developed a murder mystery games-based learning approach specifically for healthcare professionals, creating 12 emergency-themed scripts designed around emergency response competencies.
The format lends itself naturally to clinical reasoning. Learners can gather evidence, evaluate competing explanations, question characters and connect seemingly unrelated information before deciding what happened and what should happen next.
See the published murder mystery healthcare education example here.
The mechanic: Investigation
Rather than immediately focusing on performing the correct intervention, learners first have to determine what the evidence is telling them.
3. Tabletop Role Playing
Games such as Dungeons & Dragons work partly because neither the players nor the person running the game knows precisely how the story will unfold. Healthcare educators have experimented with bringing that same unpredictability to simulation.
The Novel Academic Tabletop 2022 (NAT22) model combines simulation with tabletop role playing. Learners choose clinical actions, but dice help determine their outcomes. The scenario therefore has learning objectives without requiring a single predefined pathway. A patient might fail to respond to initial treatment, another problem might suddenly demand attention, or learners may need to reconsider their priorities.
Explore the NAT22 tabletop role playing simulation model.
The mechanic: Uncertainty
Learners must adapt rather than simply follow the expected path through a familiar scenario.
4. Minute to Win It
Not every creative simulation needs an elaborate storyline. Nursing educators adapted the television gameshow format Minute to Win It® to help students develop clinical judgment surrounding postpartum hemorrhage. Teams moved through seven timed challenges focused on recognition, analysis, action and evaluation. Student scores improved significantly across all four components following the activity.
The idea is readily adaptable: break a larger learning objective into focused challenges and give teams a limited amount of time to solve each one.
Read about the postpartum hemorrhage Minute to Win It activity
The mechanic: Urgency
Time limits force learners to prioritize, communicate quickly and turn knowledge into action.
5. Choose Your Own Adventure
Traditional simulations already involve decisions and consequences. A choose-your-own-adventure structure makes that relationship explicit. When in-person simulation sessions were disrupted during the pandemic, educators transformed an existing critical care scenario into “Ready Patient One”, an interactive online game combining choose-your-own-adventure storytelling with escape room-style puzzles.
Learners’ decisions determined how the story progressed, while puzzles served as gateways requiring them to apply critical care concepts. More than 90% of surveyed participants expressed interest in completing additional choose-your-own-adventure games.
Explore information about the “Ready Patient One” online game.
The mechanic: Consequence
Learners see more explicitly how one decision changes what happens next and can potentially replay the experience to explore a different path.
6. Tabletop Simulation
At the other end of the spectrum from high-fidelity environments is a surprisingly simple idea: put the simulation on a table. Visually Enhanced Mental Simulation (VEMS) uses visual representations of patients, clinicians, equipment and environments that participants manipulate while talking through a scenario. A 2025 example, “Let’s Go on Safari”, deliberately used a nonmedical scenario to focus participants on teamwork and collaboration rather than clinical complexity.
This kind of format can create a low resource, low stakes environment where participants can stop, discuss, reposition resources and explore alternatives together.
Read about the Let’s Go on Safari VEMS approach.
The mechanic: Collaboration
Because the scenario is physically and verbally constructed by the group, learners have to externalize their thinking and solve the problem together.
Borrow the Mechanic, Not Just the Game
The takeaway isn’t that every simulation center needs an escape room, a set of dice or a gameshow buzzer. It’s that healthcare educators can borrow mechanics from other experiences and use them intentionally.
Ready to explore what’s possible for your simulation program?
From supporting innovative learning experiences to helping programs manage, capture and evaluate simulation more effectively, EMS works with healthcare educators to build simulation environments around their goals.
Schedule a discussion with an EMS solutions expert to explore what’s possible for your program.