Digitalization through the use of Ren'Py-Based interactive learning experiences in physiotherapy and rehabilitation...

Advances in health professions education increasingly emphasize the use of digital technologies to enhance student engagement and support diverse learning needs. In physiotherapy training, particularly in technically complex subjects like electrotherapy, conventional instruction may fall short in fostering active learning and knowledge retention. Game-based platforms such as Ren'Py offer an opportunity to integrate interactive, scenario-based learning into the curriculum. This study aimed to assess the impact of Ren'Py-based digital materials on learning outcomes by comparing conventional, digital, and hybrid teaching models in an undergraduate electrotherapy course.

This single-blind, three-arm randomized controlled trial was conducted between October-December 2024 at the Department of Physiotherapy and Rehabilitation. Eighty second-year physiotherapy students who had not previously taken the course were randomly assigned via computerized sequence to one of three groups: Conventional Education Group (CEG, n = 23), Digital Education Group (DEG, n = 29), or Conventional and Digital Education Group (CaDEG, n = 28). Instructional delivery included theoretical and practical sessions, followed by theoretical and practical exams. Outcomes included exam scores, the Cognitive Load Scale, the Attitude Scale Towards the Physiotherapy Profession, and the Educational Materials Motivation Survey. The data were analyzed using SPSS 27.0 package program. The parametric ANOVA test was used for normally distributed data, and the nonparametric Kruskal-Wallis test was used for nonnormally distributed data. Post-hoc analyses were performed using the Bonferroni test for normally distributed data and the Dunn-Bonferroni test for non-normally distributed data. A p < 0.05 level of significance was accepted for all findings.

Theoretical exam scores were similar between groups (CI(95%) = 0.00 to 0.07; p = 0.616), but practical exam scores were significantly different (CI(95%) = 0.03 to 0.30; p < 0.001); both CEG and CaDEG performed better than DEG (CI(95%) = 2.22 to 18.01, p = 0.007 and CI(95%)=-18.51 to -3.52, p = 0.002, respectively). In ASTPP scores, no significant difference was observed between the groups in pre-training, post-training, post-pre-training differences, and in within-group comparisons in any of the CEG, DEG and CaDEG groups (CI(95%) = 130.13 to 136.16, p = 0.858; CI(95%) = 131.91 to 137.08, p = 0.511; CI(95%)=-1.27 to 3.97, p = 0.852; CI(95%)=-4.59 to 3.63, p = 0.987; CI(95%)=-7.31 to 5.10, p = 0.335; CI(95%)=-5.22 to 0.57, p = 0.075, respectively). Cognitive load was significantly higher in the CEG group compared to DEG and CaDEG (CI(95%)=-2.04 to 0.09, p = 0.020; CI(95%)=-0.01 to 2.11, p = 0.016, respectively). IMMS scores were significantly higher in the CaDEG group than in CEG (CI(95%) = 1.77 to 30.32, p = 0.022).

Face-to-face and hybrid models were more effective than digital-only instruction for developing practical skills in physiotherapy education. The hybrid model also reduced cognitive load and increased motivation. These findings suggest that integrating tools like Ren'Py into conventional instruction may enhance learning when used as a complement. Further studies with larger samples and extended durations are recommended.

This study was retrospectively registered on ClinicalTrials.gov (NCT07274839).