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Strategy Submission

Using Gamification to Validate the Need for Evidence Based Practice: The Marshmallow Challenge


Shannon S. Layton





Tedra S. Smith, DNP, CRNP, CPNP-PC, CNE


University of Alabama at Birmingham


Competency Categories:

Evidence-Based Practice, Quality Improvement, Teamwork and Collaboration

Learner Level(s):

Continuing Education, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development

Learner Setting(s):

Classroom, Skills or Simulation Laboratories

Strategy Type:

General Strategy

Learning Objectives:

Knowledge: After exposure to the evidence-based practice (EBP) teaching strategy the learner will be able to verbalize the relevance of evidence-based practice in driving and sustaining quality improvement in the healthcare environment (EBP, QI). Skills: using low fidelity simulation the learner will conduct PDSA cycle(s) without the benefits of evidence-based knowledge (QI). During the debriefing portion learners will verbalize awareness of the need to incorporate EBP into routine approaches to care (EBP). Attitudes: Value the role of EBP in directing continuous quality improvement in the patient care environment (EBP,QI)

Strategy Overview:

Purpose: To provide faculty and students with access to a low fidelity simulation that simultaneously engages auditory, visual and kinesthetic learners in order to promote use of evidence based practice. This strategy is adapted from Design Thinking Expert Dennis Boyle’s exercise The Marshmallow Challenge originally used to foster team communication and critical thinking during a difficult challenge. Our faculty adapted it to drive home the advantages of using evidence based practice, teamwork and effective communication to solve difficult healthcare related challenges.

Submitted Materials:

Blinded-_instructional_video_link.pdf -
QSEN_Debrief_Instructor_Expanded_Version.pdf -
QSEN_Debrief_Instructor_Short_Version.pdf -

QSEN_Teaching_Strategy_Video_Outline_Marshmallow_Challenge..pdf -

QSEN-Student-Self-Reflection_Individual_Team_Debrief.pdf -

Additional Materials:

Marshmallow Challenge Game (Dennis Boyle): 20 spaghetti noodles per team, one yard length of masking tape, one yard length of sting, one giant/large size marshmallow, one pair of scissors per group. Background Music (optional) Debriefing Tool (attached) Debriefing Video (attached) Instructional Video (attached)

Evaluation Description:

Debriefing of students using the materials provided allows for instructor evaluation and remediation of objectives.
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