Patients undergoing surgical intervention may suffer several types of risks and complications related to the surgery and an important consequence is an increase in mortality. According to the World Health Organization (WHO), the rate of major complications resulting from surgical procedures ranges from 3% to 16%, with a mortality rate raging 0.4% to 0.8%. Both major complications and mortality rate could be preventable in half of the cases.1 However, in developing countries, such as Brazil, the mortality rate ranges from 5% to 10% in major surgery.1

Seeking to reduce these adverse events, the World Health Organization created the “Safe Surgery Saves Lives Program” which includes the use of the Safe Checklist.2,3 The checklist covers the three important steps of the surgical process: anesthetic induction (Sign In), before the surgical incision (Time Out) and before the patient leaves the operating room (Sign Out).3,4 The implementation of the checklist is simple, low cost and with an estimated time of three minutes for checking each step, facilitating team communication and reducing process failures.4,5 Although studies have shown that application of the checklist is associated with improved postoperative results, with reduced morbidity/mortality and complications, the implementation may face organizational and cultural barriers.4,5 These barriers include the lack of recognition of the importance of the protocol; lack of communication and engagement; lack of understanding of the process as is everyone's responsibility; and lack of widespread training involving different team members.3, 4, 5, 6

These barriers can be overcome through continuing education that covers the training of all professionals, but also strategies that make it possible to raise sensitization and awareness of the team about the importance of the protocol.3, 4, 5, 6 Escape rooms offer an innovative approach to training and have the aim of developing a variety of different competencies, with the aim of changing behavior. This approach provides the essential development in critical thinking, teamwork, collaborative work, effective communication between professionals, creativity, decision making and working under pressure that are required for the practice of safe surgery. Escape room has been used in medical education, but there is no report on using in for safe surgery training.