Gamified learning in health sciences education: Terminology and considerations

Health sciences educators around the world consistently endeavor to make their content more engaging and enjoyable for students. Many utilize active learning methods, such as flipped classroom, team-based learning (TBL), and case-based learning (CBL). A recent meta-analysis reported that TBL, CBL, and simulation-based learning are among the most effective approaches for improving test and satisfaction scores in medical education.1 Another innovative and similarly active pedagogical approach is gamified learning. This collection of playful and adaptable teaching tools has garnered widespread attention in health sciences education, with growing publication trends over the past few decades across disciplines, including medicine,2 dentistry,3 pharmacy,4 and nursing,5 and Science, Technology, Engineering, Mathematics (STEM),6 Despite inconsistent findings regarding content acquisition and retention, it is well documented that games—or elements thereof—can meaningfully enrich both tangible and intangible aspects of the learning experience.7-10 This Special Issue of Anatomical Sciences Education showcases the breadth, innovation, and creativity of gamified learning scholarship in the health sciences, including anatomy and its various subdisciplines. For the sake of consistency, articles included in this Special Issue employ gamified learning terminology according to the descriptions and Venn diagram figure in Stiver et al.,11 with a few updates and clarifications (Figure 1). Some educators may question whether gamified pedagogical approaches are suitable for their courses or even appropriate for formal educational settings, but one aim of this Special Issue is to help reduce stigma. First, it is important to recognize that gamified learning is substantiated by numerous learning theories and frameworks.22 For instance, game-based learning enables learners to actively engage with content to create their own understanding (e.g., constructivist learning theory23), make iterative choices that build competence and motivation (e.g., self-determination theory24), and contribute to a social learning environment by competing with, cooperating with, and/or observing their peers (e.g., social cognitive theory25). A variety of articles in this Special Issue employ different learning theories and discuss the impact of gamified learning on the learner experience.26-28 Moreover, the Association of American Medical Colleges recognizes “Games” as a distinct instructional method in their MedBiquitous® list of Standardized Instructional and Assessment Methods and Resource Types, established in March 2016.29 One of the many strengths of gamified approaches is how readily you can adapt them to suit different learning contexts, from addressing specific learning objectives to complementing broader content and audience related considerations. As exemplified in the breadth of articles included in this Special Issue, gamified learning can be employed to review and consolidate previously learned content30 or provide a scaffold for learners to apply content in new contexts.31 It is important to note that many of the foundational concepts and game mechanics can be applied to almost any discipline. This Special Issue includes articles tackling everything from specific topics like embryology,32 neuroanatomy,33, 34 and histology17, 35 to more general medical sciences.16, 36 Additionally, many of the articles highlight how game-based learning and gamification can be applied to a wide range of academic levels, including high school,18 undergraduate,26, 31 graduate,35 and professional programs.37, 38 Several articles in this Special Issue discuss the importance of involving students in the research process beyond just the final stage as participants, including having learners actively engage in the game design process.32, 39, 40 Similarly, many of the gamified approaches were spearheaded by students, which emphasizes their enthusiasm for getting involved in creating innovative teaching tools. Accessibility is a critical component of gamified learning and should be embedded throughout the process—from idea to gameplay. Games can unintentionally exclude learners by incorporating elements that assume equal visual, auditory, motor, or cognitive abilities41; however, when it comes to educational games, it is imperative to consider adaptable components that enable inclusive learning for all students. For more on this topic in this Special Issue, see Stover et al.31 and Jeter et al.33 Digital games are not prominently featured in this Special Issue, but there are still many topics worth considering when integrating technology into gamified learning. Lau et al.42 propose a framework for implementing digital games in anatomy education and raise some ethical concerns (e.g., using images of anatomical donors). Additionally, the responsible and transparent use of artificial intelligence, whether for game design or integrated into gameplay, is just a few topics for future discussion. Collectively, this Special Issue illustrates that gamified learning is not just a passing fad driven by novelty and gimmicks. It is a versatile collection of educational tools supported by robust learning theories and applicable to nearly any combination of learning objectives, content, and context. Like most pedagogical approaches, the effectiveness of gamified learning depends on making intentional and ethically informed design choices, accounting for learner diversity, and—when applicable—integrating technology in a deliberate and responsible manner. Carefully considering these elements reinforces the sustainable and credible use of gamified learning in contemporary health sciences education and beyond. Jeremy J. Grachan: Conceptualization; writing – original draft; writing – review and editing. Arthur Chin Haeng Lau: Conceptualization; writing – original draft; writing – review and editing. Mikaela L. Stiver: Conceptualization; writing – original draft; writing – review and editing. Mikaela L. Stiver created Figure 1.