The effect of the virtual escape room method on pediatric drug administration knowledge, self-efficacy, clinical comfort, and anxiety in nursing students: A randomized controlled study

This study was conducted to determine the effect of the pediatric medication management virtual escape room method on nursing students' knowledge level, self-efficacy, clinical comfort, and anxiety levels.The study was designed as a randomized controlled experimental study including pretest, posttest, and six-week follow-up measurements. The research was carried out between November 2024 and September 2025. The study sample consisted of 70 third-year nursing students enrolled at a public university. The intervention group participated in a virtual escape room activity related to pediatric medication management, while the control group received the standard curriculum content. Data were collected using the Pediatric Medication Management Knowledge Form, the Self-Efficacy in Pediatric Medication Administration Scale for Nursing Students, and the Clinical Comfort and Anxiety Assessment Scale for Pediatric Nursing Students. Statistical analyses were performed using SPSS 23.0. Differences between groups were evaluated with independent samples t-test and chi-square test, while relationships between numerical variables were analyzed using Pearson correlation. Changes in variables over time by group were assessed with a mixed-design ANOVA, and Bonferroni correction was applied for post-hoc comparisons. A significance level of p < .05 was adopted for all analyses.According to the findings, the intervention group had significantly higher pediatric medication management knowledge scores compared to the control group (F = 4.563, p = .012, η² = .063). A significant increase in clinical comfort was observed in the intervention group at posttest and follow-up, while no significant change occurred in the control group (F= 0.634, p = .429, η² = .009; F = 1.632, p = .206, η² = .023). Additionally, self-efficacy scores increased significantly, whereas clinical anxiety levels decreased in the intervention group (F = 4.430, p = .039, η² = .061). In conclusion, the virtual escape room method for pediatric medication management was found to be effective in improving knowledge, self-efficacy, and clinical comfort, while reducing anxiety levels among nursing students. These findings provide strong evidence supporting the use of gamification-based methods in pediatric nursing education. Future studies are recommended to test the generalizability of this method with larger samples in different universities or clinical settings and to examine its long-term effects on professional performance and patient safety outcomes. Keywords: Nursing Education; Gamification; Self-Efficacy; Pediatric Medication Management, Virtual Escape Room