Student perceptions of gamified audience response system interactions in large group lectures and via lecture capture technology

Evaluation of ImpENSA technology-enabled behaviour change module delivered to healthcare professionals in South Africa to improve micronutrient nutrition during the first 1000 days

Healthcare professionals (HCPs) have vital roles in providing evidence-based care to promote healthy micronutrient nutrition in early life. Providing such care requires scalable training to strengthen knowledge and confident application of effective behaviour change skills. Among 33 public and private HCPs (primarily dietitians) in South Africa, we evaluated the behaviour change aspects of a technology-enabled National Qualification Sub-Framework level 6 programme, Improving Early Nutrition and Health in South Africa ('ImpENSA'). This programme comprises two self-directed micronutrient and behaviour change knowledge-based eLearning and one facilitated online practical skills modules to improve maternal and infant micronutrient nutrition. Using assessments, questionnaires and interviews, we collected data at baseline, after module completion and at 3-month follow-up after programme completion. Questionnaire and interview data showed major improvements in understanding of and attitudes towards person-centred behaviour change support immediately following the eLearning module on behaviour change. The assessment pass rate increased from 38% at baseline to 88% postmodule, demonstrating significant knowledge gain in behaviour change support. Intention to change practice towards a person-centred approach was high and many had already started implementing changes. Three months postprogramme, support was centred around patients' needs. Open relationships with patients, improved patient outcomes and increased job satisfaction were among reported outcomes. Many reported becoming better change facilitators and reflective practitioners. Additional improvements in understanding and attitudes to behaviour change support were evident, reinforced by making changes and experiencing positive outcomes. The findings suggest that technology-enabled learning can equip HCPs with knowledge and skills to effectively support behaviour change for healthy micronutrient nutrition during pregnancy and infancy.

Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022

BACKGROUND

The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy.

METHODS

Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded.

RESULTS

Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs.

CONCLUSION

These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.

Interactive Quiz-Based Anatomy Teaching for Medical Undergraduate Students

BACKGROUND

Anatomy is one of the most volatile subjects and needs the learner to understand and retain a lot of information and terms. It is thus very important to continuously upgrade the methodology from the traditional didactive to interactive teaching to make the student an active learner and engage him in the learning process to categorize and analyze anatomical facts and knowledge.

AIMS AND OBJECTIVES

The study was done to compare the learning outcomes and perception of medical students towards didactic lectures and interactive quiz-based lectures in anatomy.

METHODOLOGY

The study was conducted amongst the 200 Year 1 medical undergraduate students enrolled in the Department of Anatomy at Dr. Ram Manohar Lohia Institute of Medical Sciences, located in Lucknow, India. The 200 students comprised 120 males (60%) and 80 females (40%). The mean age of male students was 19.67 years and of females was 19.52 years. The students were divided into two groups of hundred students each by a method of convenience sampling. Students of group I were taught by an interactive quiz-based lecture and group II by a traditional didactic lecture. A pre- and post-test were conducted for both groups and feedback for both methods was taken by using a pre-validated feedback form based on a 5-point Likert scale.

RESULTS

On statistical analysis, it was found that in the post-test the performance of group I taught by the interactive quiz-based study was better as compared to group II taught by traditional didactive teaching, but was not statistically significant (p=0.233, p>0.05). The feedback from students revealed that 45.9% of them strongly agreed and 44.9% agreed with the fact that quiz-based lectures are better than routine lectures.

CONCLUSIONS

Results of the present study clearly indicate that the introduction of quiz-based anatomy teaching for undergraduate medical students was well received and appeared to improve their learning outcomes in the form of increased attention and participation during class and would lead to better retention of the topics taught during interactive lectures. To the best of our knowledge, no previous study has been done to document the efficacy of quiz-based teaching for the subject of anatomy.

Managing Gamified Programming Courses with the FGPE Platform

E-learning tools are gaining increasing relevance as facilitators in the task of learning how to program. This is mainly a result of the pandemic situation and consequent lockdown in several countries, which forced distance learning. Instant and relevant feedback to students, particularly if coupled with gamification, plays a pivotal role in this process and has already been demonstrated as an effective solution in this regard. However, teachers still struggle with the lack of tools that can adequately support the creation and management of online gamified programming courses. Until now, there was no software platform that would be simultaneously open-source and general-purpose (i.e., not integrated with a specific course on a specific programming language) while featuring a meaningful selection of gamification components. Such a solution has been developed as a part of the Framework for Gamified Programming Education (FGPE) project. In this paper, we present its two front-end components: FGPE AuthorKit and FGPE PLE, explain how they can be used by teachers to prepare and manage gamified programming courses, and report the results of the usability evaluation by the teachers using the platform in their classes.

Taking the pulse of a classroom with a gamified audience response system

BACKGROUND AND OBJECTIVE

This paper presents an empirical study of a gamified mobile-based assessment approach that can be used to engage students and improve their educational performance.

METHOD

A gamified audience response system called G-SIDRA was employed. Three gamification elements were used to motivate students in classroom activities: badges for achievements to increase engagement, points to indicate progression and performance in the subject and ranking for promoting competitiveness. A total of 90 medical students in a General and Descriptive Anatomy of the Locomotor System course were taught using G-SIDRA in the academic year 2019/2020. Smart bracelets were configured to collect heart rate measurements from 30 students with the aim of evaluating the impact of the gamification elements. The control group consisted of a sample of 110 students enrolled on the same course in the academic year 2016/2017 using non-gamified SIDRA.

RESULTS

Statistically significant differences were found between multiple choice questions (MCQ) scores obtained by using SIDRA and G-SIDRA in the four experiments (U = 1.621,50, p < 0,01 for Exp1; U = 1.950,00, p < 0,01 for Exp2; U = 955,00, p < 0,01 for Exp3; U = 2.335,00, p < 0,01 for Exp4). In the students' final exam grades, statistically significant differences between students that used G-SIDRA as opposed to SIDRA (T(157) = 3.992; p = 0.044) were obtained. Concerning gamification elements, statistically significantly differences were found in comparing the pulse increases after and before the badge event in the four experiments (U = 2.484,00, p = 0,038 for Exp1; U = 2.109,50, p = 0,046 for Exp2; U = 1.790,50, p = 0,025 for Exp3; U = 1.557,0, p = 0,048 for Exp4). However, there are not statistically significant differences between the pulse increases after and before the ranking event in the four experiments. In a 5-point Likert-type scale, the students expressed satisfaction with G-SIDRA (M = 4.552) and thought the system helped to better understand both theoretical and practical concepts (M = 4.092). Their global assessment of the G-SIDRA platform was 4.471.

CONCLUSIONS

Of the three gamification elements used in the study, only badge has an effect on heart rate. Better student responses and academic performance were achieved when using G-SIDRA. Nevertheless, more research is required to evaluate the impact of the gamification elements on the motivation, engagement and performance of students. Physiological measures are promising approaches for gamification elements evaluation.

Effects of Gamification on the Benefits of Student Response Systems in Learning of Human Anatomy: Three Experimental Studies

This paper presents three experiments to assess the impact of gamifying an audience response system on the perceptions and educational performance of students. An audience response system called SIDRA (Immediate Audience Response System in Spanish) and two audience response systems with gamification features, R-G-SIDRA (gamified SIDRA with ranking) and RB-G-SIDRA (gamified SIDRA with ranking and badges), were used in a General and Descriptive Human Anatomy course. Students participated in an empirical study. In the academic year 2019–2020, a total of 90 students used RB-G-SIDRA, 90 students employed R-G-SIDRA in the academic year 2018–2019, and 92 students used SIDRA in the academic year 2017–2018. Statistically significant differences were found between final exam grades obtained by using RB-G-SIDRA and SIDRA, U = 39.211 adjusted p = 0.001 and RB-G-SIDRA and R-G-SIDRA U = 31.157 adjusted p = 0.015, thus finding strong evidence with respect to the benefit of the badges used in RB-G-SIDRA. Moreover, in the students’ SIDRA systems scores, statistically significant differences were found between RB-G-SIDRA and SIDRA, U = −90.521 adjusted p < 0.001, and between R-G-SIDRA and SIDRA, U = −87.998 adjusted p < 0.001. Significant correlations between individual and team scores were also found in all of the tests in RB-G-SIDRA and G-SIDRA. The students expressed satisfaction, engagement, and motivation with SIDRA, R-G-SIDRA, and RB-G-SIDRA, thus obtaining a final average assessment of 4.28, 4.61, and 4.47 out of 5, respectively. Students perform better academically with gamified versus non-gamified audience response systems. Findings can be used to build a gamified adaptive learning system.

Anonymous Audience Response Technology in Image-Based Quiz (IBQ) Neuropathology Lecture for Undergraduate Pre-clinical Medical Students: a Comparison with Traditional Lectures

Pathology teaching, an intensively image loaded discipline, poses a significant challenge in its delivery. A lot of effort has been placed into sourcing teaching methods that could effectively enhance students' understanding and knowledge retention in this discipline. We describe for the first time in the literature the use of an image-based quiz (IBQ) to deliver a neuropathology lecture. The participating medical students were randomised into either the study group (IBQ) or the control group (traditional lecture, TL). The students were asked to complete the pre- and post-multiple choice question (MCQ) test before and after attending either of the allocated interventions. In the IBQ group, the students were presented with image-based quizzes, and answers to the quizzes were projected in real-time on screen. The students in the TL group were given the usual, traditional lecture. A total of 75 third-year medical students participated in this study. The participants were recruited from third-year medical students representing two different academic years. There was no significant difference in the pre- and post-MCQ scores between the IBQ and TL groups. However, a significant improvement in the mean scores for the pre- and post-MCQ results in both the study (p = 0.001; 95% CI 0.572-1.954) and control (p < 0.001; 95% CI 0.561-1.763) groups was observed. We found that the IBQ was a simple, personalised, and cost-effective digitalised tool which our study suggests it to be as effective as the traditional lecture in the delivery of pathology knowledge in undergraduate medical students.

Student Perception and the Effectiveness of Kahoot!: A Scoping Review in Histology, Anatomy, and Medical Education

The impact of the Covid-19 pandemic has presented challenges in medical education particularly, with development of online learning in a short time period. Notably there has been a significant increase in the use of digital technology applications to meet this challenge. For instance, in the first quarter of 2020 the game-based software Kahoot! reported a threefold increase in players and a fivefold increase in asynchronous learning globally. However, there is limited research into the use of game-based digital technology applications such as Kahoot! and the associated learning theories, particularly in histology, anatomy, and medical education. This scoping review explored the utilization, outcome scores, and student perceptions of learning with the application of Kahoot! in histology, anatomy, and medical education. Online databases were used to identify articles published between 2013 and 2021 from which 12 articles were included in the review. The majority of articles supported positive student outcomes including improved collaborative learning, improved knowledge of content, attendance, and participation. Minor negative aspects included increased time on task, overwhelming learning content, and distractions due to gadgets. None of the articles included a control group. The main educational theories identified were active learning followed by social and constructivism learning theory. In light of the Covid-19 pandemic a rapid and fundamental shift in how digital applications are being used in educational institutions has evolved. Further research on learning frameworks and studies with control groups is required to evaluate Kahoot! as a potentially valuable online application in histology, anatomy, and medical education.

Gamification and Game-Based Strategies for Dermatology Education: Narrative Review

BACKGROUND

Game-based approaches, or gamification, are popular learning strategies in medical education for health care providers and patients alike. Gamification has taken the form of serious educational games and simulations to enable learners to rehearse skills and knowledge in a safe environment. Dermatology learners in particular may benefit from gamification methods, given the visual and procedural nature of the field.

OBJECTIVE

This narrative review surveys current applications of gamification within general medical training, in the education of dermatology students, and in dermatology patient outreach.

METHODS

A literature search was performed using PubMed, Google Scholar, and ResearchGate to access and review relevant medical education- and dermatology-related gamification studies published in peer-reviewed journals. Two independent researchers with education and experience in dermatology screened publications to select studies featuring a diversity of gamification approaches and study subjects for in-depth examination.

RESULTS

A total of 6 general medical education-related and 7 dermatology-specific gamification studies were selected. Gamification generally increased motivation and engagement, improved reinforcement of learning objectives, and contributed to more enjoyable and positive educational experiences compared to traditional modes of instruction. Enhancing examination scores, building confidence, and developing stronger team dynamics were additional benefits for medical trainees. Despite the abundance of gamification studies in general medical education, comparatively few instances were specific to dermatology learning, although large organizations such as the American Academy of Dermatology have begun to implement these strategies nationally. Gamification may also a provide promising alternative means of diversifying patient education and outreach methods, especially for self-identification of malignant melanoma.

CONCLUSIONS

Serious games and simulations in general medical education have successfully increased learner motivation, enjoyment, and performance. In limited preliminary studies, gamified approaches to dermatology-specific medical education enhanced diagnostic accuracy and interest in the field. Game-based interventions in patient-focused educational pilot studies surrounding melanoma detection demonstrated similar efficacy and knowledge benefits. However, small study participant numbers and large variability in outcome measures may indicate decreased generalizability of findings regarding the current impact of gamification approaches, and further investigation in this area is warranted. Additionally, some relevant studies may have been omitted by the simplified literature search strategy of this narrative review. This could be expanded upon in a secondary systematic review of gamified educational platforms.

A Tale of Two Institutions: Analyzing the Impact of Gamified Student Response Systems on Student Anxiety in Two Different Introductory Biology Courses

Anxiety can impact overall performance and persistence in college. Student response systems (SRSs), real-time active-learning technologies used to engage students and gauge their understanding, have been shown to elicit anxiety for some students. Kahoot! is an SRS technology that differs from others in that it involves gamification, the use of gamelike elements. Recent studies have explored the impact of active-learning strategies on student anxiety across different institutions, but there is little known about how Kahoot! impacts student perceived anxiety, especially in comparison with other active-learning strategies. In two complementary yet parallel studies of introductory biology courses at a western research-intensive institution (n = 694) and a southeastern research-intensive institution (n = 60), we measured students' perceived anxiety. We then explored how students were influenced by nongraded Kahoot! play and other elements of instruction. Using previously developed and course-specific pre- and post-course surveys, we found students at both universities agreed that nongraded Kahoot! play caused less anxiety compared with other pedagogical practices, such as working in small groups or reading the textbook. After playing Kahoot!, lower-performing students demonstrated greater engagement and lower levels of anxiety compared with their peers, suggesting that Kahoot! may be a particularly engaging active-learning strategy for these students.

Fostering Careers in Medical Education

Many careers are available to psychiatrist-educators, and residents should learn about these pathways in addition to developing a core set of teaching skills regardless of their intended career trajectory. Clinician-Educator Programs offer structured opportunities for residents to explore advanced concepts, practice teaching skills, pursue scholarship, and receive mentorship in medical education. Women and persons from minority groups, particularly people of color and gender-diverse individuals, have long been passed over in the promotions process, and correction of these inequities is essential to creating a robust workforce of clinician-educators.

Gamification of health professions education: a systematic review

Gamification refers to using game attributes in a non-gaming context. Health professions educators increasingly turn to gamification to optimize students' learning outcomes. However, little is known about the concept of gamification and its possible working mechanisms. This review focused on empirical evidence for the effectiveness of gamification approaches and theoretical rationales for applying the chosen game attributes. We systematically searched multiple databases, and included all empirical studies evaluating the use of game attributes in health professions education. Of 5044 articles initially identified, 44 met the inclusion criteria. Negative outcomes for using gamification were not reported. Almost all studies included assessment attributes (n = 40), mostly in combination with conflict/challenge attributes (n = 27). Eight studies revealed that this specific combination had increased the use of the learning material, sometimes leading to improved learning outcomes. A relatively small number of studies was performed to explain mechanisms underlying the use of game attributes (n = 7). Our findings suggest that it is possible to improve learning outcomes in health professions education by using gamification, especially when employing game attributes that improve learning behaviours and attitudes towards learning. However, most studies lacked well-defined control groups and did not apply and/or report theory to understand underlying processes. Future research should clarify mechanisms underlying gamified educational interventions and explore theories that could explain the effects of these interventions on learning outcomes, using well-defined control groups, in a longitudinal way. In doing so, we can build on existing theories and gain a practical and comprehensive understanding of how to select the right game elements for the right educational context and the right type of student.

Development of Gamified, Interactive, Low-Cost, Flexible Virtual Microbiology Labs That Promote Higher-Order Thinking during Pandemic Instruction

The COVID-19 pandemic radically and without warning changed the laboratory learning environment for students and instructors. Students were faced with having to be receptive to new learning methods; instructors scrambled to devise innovative ways of providing a realistic lab experience for students. The demand for creative online teaching strategies and the expansion of gamified training platforms created an opportunity for the development of new and interactive lab experiences. Current online labs offer some elements of a "real" lab experience, but a system that incorporates all the tools needed to create a realistic, immersive lab environment has yet to be developed. This study examines using different gamification elements implemented in a PowerPoint-based platform. There was no cost associated with the virtual lab and it could be easily downloaded, increasing accessibility. In true gaming style, a student could "play" without restriction, without the limitations that accompany wet labs. Students were challenged with various scenarios throughout the lab, making choices and receiving feedback through the process. These features positively impacted student outcomes and improved engagement, as expressed in end-of-course evaluations. The implementation also stressed the need for further development of embedded assessments, competitive and interactive opportunities for students, and access to detailed learning analytics for instructors.

Nursing students' evaluation of a gamified public health educational webinar: A comparative pilot study

AIM

To compare undergraduate nursing students' evaluations of a gamified educational webinar to a non-gamified version. Both webinars covered the topic "Determinants of health," part of public health education.

DESIGN

A post-test evaluation design with a comparison group, and an additional qualitative component.

METHODS

First-year students reading for a Bachelor of Science in Nursing at the Malta College of Arts, Science and Technology were randomly allocated into two classes of 26 students each, and to the gamified and non-gamified webinars. The revised "Students Evaluations of Educational Quality" questionnaire was sent to all participants. Participants were also asked to provide comments on their learning experience.

RESULTS

A total of 40 participants who attended the gamified and non-gamified webinars completed the questionnaire. Educational quality was perceived as "good" to "very good," in both groups. Most participants in the gamified webinar group remarked that gamification helped to increase their engagement and interaction.

Determining the effectiveness of a cell phone-based student response system

Objectives

This study aimed to explore the responses and understanding of students and teachers about the cell phone-based Socrative® application. Additionally, we compared the academic performance of the groups using Socrative with the one group that did not make use of this application.

Methods

During the 50 min of each endocrine physiology lecture, traditional teaching took 40 min, whereas the last 10 min were reserved for Socrative. Following the lecture, students completed small Socrative-based quizzes on their smartphones. At the end of the module, students and teachers were asked for feedback and the students’ test performances were evaluated. Data were examined by the SPSS version 20 for frequencies and gender/academic performance comparison.

Results

As many as 87% of the students responded positively to Socrative; 85% felt that the activity was fun, 84% were more actively engaged, and 71% felt more motivated. Furthermore, 90% of the students agreed that this exercise enhanced their learning. Most students agreed that Socrative helped them enhance peer-to-peer and class discussions. Students’ attitudes towards Socrative activity did not vary with respect to their gender or total screen time per day. Approximately 99% of the students preferred multiple-choice questions to true/false and short answers. Instructors perceived Socrative as an easy-to-use tool to generate discussions and assess the degree of understanding of their students. Socrative significantly enhanced exam performance.

Conclusion

Course instructors are encouraged to incorporate mobile-based applications in their lectures, which may make students’ learning more active, effective, and enjoyable, without increasing institutional expenses.

Feasibility of Kahoot! as a Real-Time Assessment Tool in (Histo-)pathology Classroom Teaching

PURPOSE

New technologies like gamification are continuously integrated into medical education during the last years. However, the benefit and implementation of such gaming platforms are not clearly studied. This analysis assesses the feasibility of Kahoot! regarding simplicity and low-cost performance as a learning/teaching tool for medical education in (histo-)pathology.

MATERIALS AND METHODS

In this feasibility pilot study, we developed 36 modules for different benign and malignant tumors, covering four major topics: gastrointestinal tract, dermatology, urogenital tract, and hematology. Each module included histomorphological text-based questions for education of 2nd-year medical students. The online gaming-platform Kahoot! was anonymously implemented before and after "classical" medical education which included discussions of histological slides for each tumor entity using Microsoft PowerPoint-based presentations in combination with microscopical demonstrations. Participating students were invited to a seven-questions evaluation about the online educational approach.

RESULTS

Overall, 23 of 51 students of the study class completed the pre- and the post-evaluation of Kahoot! in one or more organ systems. The percentage of correct answers increased from the initial mean/median of 47.2/45% to 77.2/76.3%. Simultaneously, the time for answering questions decreased by roughly 50% (from mean/median time of 9.1/8.3 seconds to 5.1/4.3 seconds) from pre- to post-assessment. The results were independent of gender; however, there were scoring differences between the different organ systems. Students positively evaluated the routine implementation of the gaming-platform Kahoot! within medical education.

CONCLUSION

Kahoot! is as a simple, direct, and low-cost application in medical teaching improving learning outcomes of pathomorphological topics with high acceptance by students. Kahoot!-based evaluations should be also performed in more advanced topics in the field of histopathology.

Teaching a difficult topic using a problem-based concept resembling a computer game: development and evaluation of an e-learning application for medical molecular genetics

BACKGROUND

Genetic testing rapidly penetrates into all medical specialties and medical students must acquire skills in this area. However, many of them consider it difficult. Furthermore, many find these topics less appealing and not connected to their future specialization in different fields of clinical medicine. Student-centred strategies such as problem-based learning, gamification and the use of real data can increase the appeal of a difficult topic such as genetic testing, a field at the crossroads of genetics, molecular biology and bioinformatics.

METHODS

We designed an electronic teaching application which students registered in the undergraduate Medical Biology course can access online. A study was carried out to assess the influence of implementation of the new method. We performed pretest/posttest evaluation and analyzed the results using the sign test with median values. We also collected students' personal comments.

RESULTS

The newly developed interactive application simulates the process of molecular genetic diagnostics of a hereditary disorder in a family. Thirteen tasks guide students through clinical and laboratory steps needed to reach the final diagnosis. Genetics and genomics are fields strongly dependent on electronic databases and computer-based data analysis tools. The tasks employ publicly available internet bioinformatic resources used routinely in medical genetics departments worldwide. Authenticity is assured by the use of modified and de-identified clinical and laboratory data from real families analyzed in our previous research projects. Each task contains links to databases and data processing tools needed to solve the task, and an answer box. If the entered answer is correct, the system allows the user to proceed to the next task. The solving of consecutive tasks arranged into a single narrative resembles a computer game, making the concept appealing. There was a statistically significant improvement of knowledge and skills after the practical class, and most comments on the application were positive. A demo version is available at https://medbio.lf2.cuni.cz/demo_m/ . Full version is available on request from the authors.

CONCLUSIONS

Our concept proved to be appealing to the students and effective in teaching medical molecular genetics. It can be modified for training in the use of electronic information resources in other medical specialties.

Socrative in Higher Education: Game vs. Other Uses

The integration of clickers in Higher Education settings has proved to be particularly useful for enhancing motivation, engagement and performance; for developing cooperative or collaborative tasks; for checking understanding during the lesson; or even for assessment purposes. This paper explores and exemplifies three uses of Socrative, a mobile application specifically designed as a clicker for the classroom. Socrative was used during three sessions with the same group of first-year University students at a Faculty of Education. One of these sessions—a review lesson—was gamified, whereas the other two—a collaborative reading activity seminar, and a lecture—were not. Ad-hoc questionnaires were distributed after each of them. Results suggest that students welcome the use of clickers and that combining them with gamification strategies may increase students’ perceived satisfaction. The experiences described in this paper show how Socrative is an effective means of providing formative feedback and may actually save time during lessons.

The efficacy of peer teaching for medical microbiology lectures

This article was migrated. The article was marked as recommended. Background: A thorough understanding of infectious diseases is needed by medical professionals; therefore effective microbiological teaching is critical. Although faculty lectures are a convenient means of educating large groups of students, they may fail to engage students and convey an understanding of the subject. Therefore, we developed peer teaching methods based on game-based learning using a reality musical talent show format. Methods: A group of student representatives were trained to lecture to a class of 300 third-year medical students via a game show format over a 3-year period (2013-2015). Results: The students reported a higher level of understanding (3.6-4.2 vs 3.6-3.9 out of 5; p Conclusions: Peer teaching did improve the students' attitude towards learning and conferred teaching skills, but the learning activity needs adjustment to reduce the out-of-class preparation time.

Project ACCRUE: Exploring Options to Increase Awareness of AIDS Malignancy Consortium Clinical Trials in North Carolina

BACKGROUND Longer lifespans conferred by antiretroviral therapy result in more time exposed to cancer risk for people living with HIV/AIDS (PLWHA). Given limited diversity in AIDS Malignancy Consortium (AMC) clinical trials, there is need for new approaches to educate PLWHA in order to improve awareness and participation in AMC trials.METHODS With input from a community advisory board, Project ACCRUE (AMC Clinical Trials at Carolina Ramp Up Enrollment) conducted a key informant interview with service providers; online organizational surveys of AMC trial awareness and resource needs; and "lunch and learn" educational sessions, including pre- and post-intervention knowledge assessments.RESULTS Providers indicated that transportation, mistrust of the medical community, and affordability were barriers to trial participation, while printed educational materials could facilitate trial recruitment. Providers indicated that their clients had concerns about participating in trials, but also recognized several benefits of participation including access to medical personnel and treatment, receipt of monetary incentives, and a feeling of satisfaction from helping others. In lunch and learn sessions, use of an audience response system to collect questionnaire data improved scores on knowledge-based items [S(55) = 460; P < .0001] compared to a pencil and paper test [S(20) = 12.5; P = .6541].LIMITATIONS Generalizability may have been compromised by the small sample size. Long-term recall was not measured, and the short retest interval may have impacted post-intervention assessments.CONCLUSIONS Service providers recognize the benefits of working with researchers to educate patients about HIV-related cancers and participation in clinical trials. Lunch and learn sessions improved knowledge and perceptions about clinical trials for PLWHA.

Transforming classroom questioning using emerging technology

Classroom questioning is a common teaching and learning strategy in postgraduate nurse education. Technologies such as audience response systems (ARS) may offer advantage over traditional approaches to classroom questioning. However, despite being available since the 1960s, ARSs are still considered novel in many postgraduate nurse education classroom settings. This article aims to explicate the attitudes of postgraduate nursing students in an Irish academic teaching hospital towards classroom questioning (CQ) and the use of ARSs as an alternative to traditional CQ techniques. The results of this small-scale study demonstrate that ARSs have a role to play in CQ in the postgraduate setting, being regarded by students as beneficial to learning, psychological safety and classroom interaction.

Systematic review of the implementation of audience response systems and their impact on participation and engagement in the education of healthcare professionals

Background

Audience response system provides a mechanism to engage larger groups as active participants in teaching sessions. However, they are traditionally based on 'fixed' closed loop system, which limits their functionality to a single geographical location, thus has the effect of confining their use to universities and other larger institutions, with a primary focus on education. Conversely, in the healthcare education context, the majority of formal education is undertaken through postgraduate training programmes, largely conducted in smaller cohorts in clinical settings.

Objective

The purpose of this review is to evaluate audience response systems in terms of feasibility of implementation and the impact on participation within the field of education of healthcare professionals, in comparison to the non-healthcare education.

Study selection

Therefore, systematic structured searches of PubMed and Medline databases for healthcare education were conducted, and Scopus, Education Resources Information Center, British Education Index, Education Abstracts, Education Administration Abstracts and PsycINFO databases for non-healthcare education databases.

Findings and conclusions

Consistent and fundamental differences were found in the studies evaluating healthcare education compared with other fields, with more difficulties encountered in implementation and a less significant impact on engagement seen. Here we discuss the consequences of these findings on the use of audience response systems and beyond.

Gaming science innovations to integrate health systems science into medical education and practice

Health systems science (HSS) is an emerging discipline addressing multiple, complex, interdependent variables that affect providers' abilities to deliver patient care and influence population health. New perspectives and innovations are required as physician leaders and medical educators strive to accelerate changes in medical education and practice to meet the needs of evolving populations and systems. The purpose of this paper is to introduce gaming science as a lens to magnify HSS integration opportunities in the scope of medical education and practice. Evidence supports gaming science innovations as effective teaching and learning tools to promote learner engagement in scientific and systems thinking for decision making in complex scenarios. Valuable insights and lessons gained through the history of war games have resulted in strategic thinking to minimize risk and save lives. In health care, where decisions can affect patient and population outcomes, gaming science innovations have the potential to provide safe learning environments to practice crucial decision-making skills. Research of gaming science limitations, gaps, and strategies to maximize innovations to further advance HSS in medical education and practice is required. Gaming science holds promise to equip health care teams with HSS knowledge and skills required for transformative practice. The ultimate goals are to empower providers to work in complex systems to improve patient and population health outcomes and experiences, and to reduce costs and improve care team well-being.

Digital games in health professions education: Advantages, disadvantages, and game engagement factors

Background: The application of digital educational games in health professions education is on expansion and game-based education usage is increasing. Methods: Diverse databases were searched and the related papers were reviewed. Results: Considering the growing popularity of educational games in medical education, we attempted to classify their benefits, flaws, and engaging factors. Conclusion: Advantages, disadvantages, and engagement factors of educational digital games used for health professions education must be the focus of attention in designing games for health professions discipline.

Digital games in medical education: Key terms, concepts, and definitions

Introduction: Game-based education is fast becoming a key instrument in medical education. Method: In this study, papers related to games were filtered and limited to full-text peer-reviewed published in English. Results: To the best of researchers' knowledge, the concepts used in the literature are varied and distinct, and the literature is not conclusive on the definition of educational games for medical education. Conclusion: This paper attempts to classify terms, concepts and definitions common to gamification in medical education.

A descriptive, cross-sectional study of medical student preferences for vodcast design, format and pedagogical approach

BACKGROUND

Vodcasts (video podcasts) are becoming increasingly popular in medical education. At A.T. Still University School of Osteopathic Medicine in Arizona (ATSU SOMA), vodcasts are an essential component of our blended learning environment, where year 2-4 students train in a contextual setting at community health centers across the U.S. Vodcasts are used far less frequently in our year 1 residential learning environment at the main campus in Arizona, but we are considering moving to significantly more interactive educational experiences with on-demand videos followed by in-class activities. The aim of this study was to determine stakeholder (i.e. medical student) preferences for vodcast design, format, and pedagogical strategies. The overall goal was to increase opportunities for students to learn with this modality.

METHODS

An interactive Qualtrics™ survey was administered to three cohorts of medical students. The survey generated quantitative and open-ended response data that addressed principles of vodcast instructional design and learning. Responses to survey items were analyzed for statistical significance using the independent samples t-test for interval data, the chi-square test for categorical data, and the Kruskal-Wallis test for ordinal data, using the post-hoc Bonferroni procedure to determine the appropriate α level. Responses to open-ended prompts were categorized using open- and axial-coding.

RESULTS

The most highly valued vodcast attributes, considered essential by all three cohorts, were clear explanations, organization, conciseness, high-yield for medical board exams, and the ability to speed vodcasts up. The least helpful vodcast attributes for all three cohorts were music and objects moving on screen. The average preferred vodcast length for each cohort was 27-28 min. There were significant differences between the less experienced learners in the residential setting and the more mature learners in the blended learning environment regarding certain vodcast attribute preferences, format of included practice questions, explanations for preferred vodcast lengths, and reasons for not viewing vodcasts.

CONCLUSIONS

Overall, learner preferences were in line with non-interactive, screen-capture type vodcasts, which have lower demands on institutional cost and faculty production time than Flash™-type interactive vodcasts. Students in the blended learning environment were much more focused on vodcast features that decreased their time commitment, including a preference for noninteractive vodcasts. Given the increase in distance learning in medical education, our results should be of value to other medical programs.

What millennial medical students say about flipped learning

Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an "all or nothing" learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide curricular improvements.

Can New Digital Technologies Support Parasitology Teaching and Learning?

Traditionally, parasitology courses have mostly been taught face-to-face on campus, but now digital technologies offer opportunities for teaching and learning. Here, we give a perspective on how new technologies might be used through student-centred teaching approaches. First, a snapshot of recent trends in the higher education is provided; then, a brief account is given of how digital technologies [e.g., massive open online courses (MOOCs), flipped classroom (FC), games, quizzes, dedicated Facebook, and digital badges] might promote parasitology teaching and learning in digital learning environments. In our opinion, some of these digital technologies might be useful for competency-based, self-regulated, learner-centred teaching and learning in an online or blended teaching environment.