Changes in high school students' interest in medical school following a physiology-based medical science competition: a questionnaire-based study

The 1^st Siriraj Medical Sciences Academic Competition (SiMSAC), themed 'Physiology,' integrated gamification and experience-enhancing activities to motivate high school students to pursue medical studies. However, evidence on whether such competitions are associated with students' interest in medical school remains limited. This study aimed to evaluate changes in high school students' interest in medical school (Med-Interest), interest in the organizing institution (SI-Interest), and self-assessed physiology knowledge following participation in a physiology-based competition, and to examine correlations with high school subject preferences and satisfaction with competition activities.

This retrospective pre-post within-subject questionnaire-based study used census sampling of respondents (99.3%, 569/573). Participants were students in grades 9-12 from 191 schools across Thailand. Data were collected after the competition using a self-developed questionnaire comprising quantitative rating scales and optional open-ended questions on participants' impressions of the competition and suggestions. Participants retrospectively rated Med-Interest and SI-Interest before and after the competition, and self-assessed physiology knowledge before preparation, during preparation, and after the competition. The evaluation also incorporated findings from the organizing committee's departmental After Action Review (AAR).

Mean (95% CI) Med-Interest increased from 4.0 (3.9-4.1) before the competition to 4.4 (4.3-4.5) after the competition, and SI-Interest increased from 3.7 (3.6-3.8) to 4.2 (4.1-4.3) (all P<.001), corresponding to relative increases of 13.8% (11.4%-16.4%) (Cohen's d = 0.562) and 23.1% (19.3%-27.2%) (Cohen's d = 0.675), respectively. Self-assessed physiology knowledge increased from 3.2 (3.1-3.3) before preparation to 3.8 (3.7-3.8) during preparation and 4.2 (4.1-4.2) after the competition (P<.001). Higher preferences for Biology, Chemistry, and Physics were associated with higher Med-Interest and SI-Interest (P<.05). Post-competition Med-Interest and SI-Interest were positively but weakly correlated with satisfaction with competition activities and subject preferences (ρ = 0.123-0.321 and 0.186-0.340; all P<.01).

Participation in a physiology-based academic competition was associated with increased interest in medical school, with a greater increase in interest in the organizing institution, along with improved self-assessed knowledge. These findings were further supported by participants' optional open-ended responses and the organizing committee's AAR, highlighting the value of integrating academic challenge, gamification, and experiential learning in pre-medical outreach and student engagement.