Effect of a gamified mobile-based application on clinical reasoning skills and learning satisfaction among medical laboratory students compared with routine internship training: a quasi-experimental study

Gamified mobile-based learning may enhance learner engagement and selected aspects of clinical reasoning in health professions education; however, evidence in medical laboratory education remains limited. This study evaluated whether a gamified mobile-based learning application, used alongside routine microbiology internship training, was associated with improvements in clinical reasoning outcomes and learning satisfaction compared with routine training alone. In this quasi-experimental study, two consecutive internship cohorts comprising 50 undergraduate medical laboratory students were assigned at the cohort level to either an intervention condition (gamified mobile-based learning application plus routine training, n = 25) or a control condition (routine training only, n = 25). Clinical reasoning was assessed using a puzzle-based integrative reasoning assessment and a key-feature examination. Learning satisfaction was measured using a validated 13-item questionnaire. Outcomes were analyzed using independent t-tests and ANCOVA, adjusting for baseline scores, age, and sex. Students in the intervention group reported significantly higher learning satisfaction than those in the control group (adjusted mean difference 16.3; 95% CI 11.5–21.1; p < 0.001). They also achieved higher scores on the puzzle-based integrative reasoning assessment (adjusted mean difference 11.6; 95% CI 2.4–20.8; p = 0.013; partial η² = 0.133), suggesting a modest but educationally meaningful improvement in integrating microbiological findings during diagnostic reasoning tasks. In contrast, key-feature examination scores improved in both groups, with no significant between-group difference ( p = 0.87). Gamified mobile-based learning may serve as a useful adjunct to routine microbiology internship training by enhancing learner satisfaction and performance on a puzzle-based assessment of integrative diagnostic reasoning. Because no additional benefit was observed on the key-feature examination, the findings support improvement in selected aspects of reasoning rather than a generalized enhancement of clinical reasoning. The intervention was designed using readily implementable mobile learning principles, supporting its potential adaptation and replication in similar educational settings. Given the quasi-experimental cohort design, these findings should be interpreted cautiously and confirmed in multicenter randomized studies involving multiple independently allocated cohorts.