Design, development and preliminary usability evaluation of “PhysioMaster”: adaptive gamified assessment tool for neurorehabilitation in undergraduate physiotherapy students

Traditional teaching methods in Neurorehabilitation often struggle to address diverse educational needs, which can lead to reduced student engagement. Gamification offers a promising strategy to enhance motivation and learning outcomes in medical education. This study aimed to design, develop, and perform a preliminary usability evaluation of "PhysioMaster," a gamified educational system tailored for the undergraduate course 'Physiotherapy in Neurological Patients. A qualitative, participatory study was conducted at Mashhad University of Medical Sciences (2023–2024) involving physiotherapy experts and students. The development process followed five phases: exploratory review, needs analysis via focus group discussions, data integration, content development, and system development. Qualitative data were analyzed using a thematic analysis approach. The formative assessment utilized a Think-Aloud protocol involving seven final-year students to identify functional and design-related barriers through qualitative observation. PhysioMaster was developed as a Progressive Web App (PWA) featuring distinct educator and student panels. The system integrates clinical scenarios with gamification elements, including points, leaderboards, avatars, and an adaptive mastery-learning system that targets individual knowledge gaps. Initial testing revealed specific technical bugs and interface challenges—such as navigation difficulties and layout clutter—which were systematically resolved to ensure system stability. This study demonstrates the successful development and initial feasibility of PhysioMaster as a gamified tool for neurorehabilitation education. While the findings confirmed high user acceptance, this formative phase prioritized functional potential over the direct measurement of learning outcomes. Further interventional research is required to rigorously assess the system's actual impact on educational effectiveness and clinical competency.