Fostering Metacognition in Anatomy Education Through Game-Based Learning and a Context-Aware AI Assistant

Anatomy education is increasingly challenged by limited access to body donor materials, high infrastructure costs, and unequal availability of advanced educational technologies. This study presents an interprofessional mobile application that integrates game-based learning with a context-aware artificial intelligence (AI) assistant supported by generative AI and retrieval-augmented generation (RAG). The platform combines high-fidelity anatomical images and videos with interactive features including practices, tournaments, AI-generated quizzes, and an AI chat assistant. The app was developed through an interdisciplinary and iterative process and evaluated during two experimental cycles involving more than 250 undergraduate students from medicine and related health sciences programs. Metacognitive outcomes were assessed through entry and exit questionnaires, learning logs, and focus groups. Students showed high engagement with the platform, completing 608 AI chat sessions, generating 1294 AI messages, and participating in 404 AI daily quizzes, with 90% receiving positive evaluations. Approximately 85% of participants considered the app a valuable complement to traditional anatomy learning. Metacognitive analysis showed improvements in conditional knowledge (33%-50%), planning (76%-88%), and depuration (76%-88%). Although some students still preferred traditional methods, many reported that the AI tools and game-based activities increased motivation, self-directed learning, and exploration of anatomical content. These findings suggest that game-based learning combined with context-aware AI can complement body donor-based anatomy education while supporting metacognitive development and improving access to high-quality anatomical resources.