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Updated: Aug 11, 2026
Assessing the Multiple Dimensions of Engagement to Characterize Learning: A Neurophysiological Perspective
Published on: July 1, 2015
A quasi-experimental crossover study on student engagement and performance in a gamified team-based learning module
1Department of Physiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.
Purpose:
Gamification is widely adopted in medical education, but recent systematic reviews reveal ambiguous effects on learning outcomes. It remains unclear whether engagement translates to learning or whether game mechanics impose extraneous cognitive load. This quasi-experimental crossover study investigated gamification's impact on student performance and engagement in Team-Based Learning.
Method:
250 first-year MBBS students at a tertiary medical college (2024-2025) participated in two physiology modules (Central Nervous System, Endocrinology) using either traditional or gamified Group Readiness Assurance Tests (GRAT) in a crossover design. Primary outcomes were Individual Readiness (IRAT) and Application Exercise (AE) scores; secondary outcomes were engagement and satisfaction.
Results:
Primary outcomes (IRAT and AE scores) did not differ significantly between formats. However, learning trajectory analysis revealed a potential mitigating trend: in Endocrinology, traditional groups showed significant IRAT-to-AE decline (-3.3 percentage points, p = 0.030, d = 0.19), whereas gamified groups' decline was non-significant (-1.9 pp, p = 0.124, d = 0.13).During the GRAT intervention phase, traditional teams outperformed gamified teams in Endocrinology (p = 0.006, d = 1.04), but not CNS (p = 0.43). Qualitative feedback was overwhelmingly positive (90% of responses), praising engagement and teamwork, though 13% cited time pressure as stressful.
Conclusions:
Gamification may enhance engagement and may provide a motivational buffer against performance decline in challenging content. This suggest gamification is a context-sensitive design choice requiring careful calibration to balance motivational benefits against cognitive costs.
