HistoSketch: A serious game to reinforce visual literacy skills

Histology requires visual literacy, which encompasses the ability to interpret, analyze, and create meaningful representations of microscopic structures. Learning by drawing enhances histological knowledge retention by reinforcing spatial awareness and pattern recognition. This study examines whether incorporating HistoSketch, a drawing game similar to Pictionary, increased drawing-based study behaviors among post-baccalaureate students enrolled in a graduate-level histology course. HistoSketch adapts the traditional board game's format by having participants draw histological structures, cellular processes, or clinical correlations while teammates attempt to identify them. The serious game was offered as an optional review session before two exams. Participants completed pre- and post-game questionnaires assessing study behaviors, attitudes toward drawing, and perceptions of the game's effectiveness. Scalar responses were analyzed quantitatively using paired t-tests, and free-text responses were analyzed using content analysis. Pre-game questionnaires indicated that most participants did not initially favor drawing as a study strategy. Post-game questionnaires revealed that participants perceived HistoSketch as helpful for identifying knowledge gaps (100%) and enhancing histology understanding (92%). While some participants planned to integrate drawing into their study strategies, others remained hesitant despite recognizing its utility. Our findings suggest that drawing-based games can enhance engagement and motivation in histology education and reinforce the importance of visual literacy skills.