A quasi-experimental crossover study on student engagement and performance in a gamified team-based learning module in physiology.
Gamification may help maintain student engagement and mitigate performance decline in challenging subjects, but its effectiveness varies by context.
Where it sits
this study against the rest of the slu-pp-332 (exercise mimetic) corpusSummary and findings
This study investigated the impact of gamification on student performance and engagement among 250 first-year MBBS students in two physiology modules. The primary outcomes measured were Individual Readiness (IRAT) and Application Exercise (AE) scores, with no significant differences found between traditional and gamified formats. A trend indicated that gamification may mitigate performance decline in challenging content.
Abstract
<h4>Purpose</h4>Gamification is widely adopted in medical education, but recent systematic reviews reveal ambiguous effects on learning outcomes. It remains unclear whether engagement translates to learning or whether game mechanics impose extraneous cognitive load. This quasi-experimental crossover study investigated gamification's impact on student performance and engagement in Team-Based Learning.<h4>Method</h4>250 first-year MBBS students at a tertiary medical college (2024-2025) participated in two physiology modules (Central Nervous System, Endocrinology) using either traditional or gamified Group Readiness Assurance Tests (GRAT) in a crossover design. Primary outcomes were Individual Readiness (IRAT) and Application Exercise (AE) scores; secondary outcomes were engagement and satisfaction.<h4>Results</h4>Primary outcomes (IRAT and AE scores) did not differ significantly between formats. However, learning trajectory analysis revealed a potential mitigating trend: in Endocrinology, traditional groups showed significant IRAT-to-AE decline (-3.3 percentage points, <i>p</i> = 0.030, d = 0.19), whereas gamified groups' decline was non-significant (-1.9 pp, <i>p</i> = 0.124, d = 0.13).During the GRAT intervention phase, traditional teams outperformed gamified teams in Endocrinology (<i>p</i> = 0.006, d = 1.04), but not CNS (<i>p</i> = 0.43). Qualitative feedback was overwhelmingly positive (90% of responses), praising engagement and teamwork, though 13% cited time pressure as stressful.<h4>Conclusions</h4>Gamification may enhance engagement and may provide a motivational buffer against performance decline in challenging content. This suggest gamification is a context-sensitive design choice requiring careful calibration to balance motivational benefits against cognitive costs.
Background
This paper addresses the impact of gamification in medical education, specifically its effects on student engagement and performance. Prior research has shown mixed results regarding the effectiveness of gamification on learning outcomes. Understanding whether gamification enhances learning or adds cognitive load is crucial for educational design.
Methods
The study utilized a quasi-experimental crossover design involving 250 first-year MBBS students at a tertiary medical college. Participants engaged in two physiology modules using either traditional or gamified Group Readiness Assurance Tests (GRAT). Primary outcomes included Individual Readiness (IRAT) and Application Exercise (AE) scores, with secondary outcomes measuring engagement and satisfaction.
Results
The primary outcomes did not show significant differences between traditional and gamified formats. However, in Endocrinology, traditional groups experienced a significant IRAT-to-AE decline of -3.3 percentage points (p=0.030, d=0.19), while the gamified groups showed a non-significant decline of -1.9 percentage points (p=0.124, d=0.13). Traditional teams outperformed gamified teams in Endocrinology (p=0.006, d=1.04), but not in the Central Nervous System module (p=0.43).
Interpretation
The findings suggest that while gamification may not significantly enhance performance overall, it may provide a motivational buffer against performance decline in challenging subjects. The effect sizes observed, particularly the significant decline in traditional groups, indicate some potential benefits of gamification, but the small effect sizes (d=0.19 and d=0.13) may not be clinically meaningful. Limitations such as the quasi-experimental design and potential biases in qualitative feedback should be considered when interpreting these results.
Key findings
- IRAT scores declined by -3.3 percentage points in traditional groups vs. -1.9 pp in gamified groups, p=0.030 and p=0.124 respectively.
- Traditional teams outperformed gamified teams in Endocrinology with p=0.006 and effect size d=1.04.
- Qualitative feedback showed 90% positive responses regarding engagement and teamwork.
- 13% of participants reported time pressure as stressful.
Limitations
- quasi-experimental design limits causal inferences
- reliance on self-reported qualitative feedback may introduce bias
- small sample size may affect generalizability
- short duration of study may not capture long-term effects