Novel application of gamification to support undergraduate anatomy: Student perceptions and performance

Anatomy is a foundational component of various medical and paramedical disciplines. Existing research has suggested that games or game elements can improve student interest in musculoskeletal (MSK) anatomy. This project builds on previous gamification and serious game work and incorporates new anatomy-based games into undergraduate anatomy education. Challenging structures and areas of difficulty were identified using previous years' exams. This informed the content and design of the games in this study: a modified Guess Who? and a group-based labeling exercise. Both were provided in optional study sessions available to students in an introductory undergraduate anatomy and physiology course. The data collected includes pre- and post-session questionnaires, labeling times, and midterm exam performance. Few participants reported previously incorporating games into their own MSK anatomy study time, but the majority believed that anatomy-specific games would positively improve their confidence, engagement, and motivation in the course (LIKERT scores all >4.5/5). The games improved students' self-perceived confidence (92% somewhat or strongly agree) and anatomy knowledge (100% somewhat or strongly agree), and provided opportunity for peer collaboration that is often missing in large undergraduate anatomy classes. There were, however, inconsistent effects in exam performance seen across different sections of the course (in-person vs virtual). These findings suggest that the benefits of educational games may depend on contextual factors that require further exploration. Future studies should also explore extending this approach to other challenging topics identified by students.