Abstract：
Gamification is emerging as an active learning innovation in medical education to enhance student engagement and promote life-long learning in a unique and collaborative environment. Clinical enzymology in biochemistry is one of the core topics in the medical curriculum. However, students face challenges in comprehension and retention of information. Hence, CARd & Board GAmes in Medical Education (CARBGAME) was introduced and evaluated for its effectiveness in enhancing learning, application, and retention of knowledge in clinical enzymology via gamification context. This mixed-method study involved 150 first-year undergraduate medical students. Before the game, students completed a pre-test in clinical enzymology. Later they were divided into 25 small groups to compete in the board game designed for enzymology in biochemistry. The students took turns throwing the dice and answering the questions on the game board to continue moving forward. The first team to reach 100 and solve the case-based question was deemed the winner. Following the board game, the students took up the post-test to compare the educational impact of the innovation. Also, the subsequent internal assessment scores were compared with previous batch who were not implemented with this intervention. Then students evaluated the effectiveness of CARBGAME-Clinical Enzymology using a 32-item questionnaire on 5-point Likert scale. The feedback obtained on a 10-point rating scale and for qualitative analysis, students\' and faculty perceptions were recorded in small groups. CARBGAME received overwhelmingly positive feedback from both students and faculty. It was perceived well by students for being fun, relevant, consistent, motivating, collaborative, and promoting experiential learning. The game\'s low-stakes approach, effective feedback, and sense of accomplishment were highly appreciated, making it a valuable tool for education. A significant improvement in knowledge was recorded, from a mean score of 8.37 ± 1.126 on a 20-point scoring scale before the game to 16.53 ± 1.219 after with a p-value of 0.0001. The comparison of the internal assessment scores between the intervention and non-intervention group of students also showed a significant improvement among those implemented with CARBGAME (p < 0.0001). The CARBGAME innovation has achieved the intended outcome of promoting active learning and enhanced performance in clinical enzymology. Highly positive responses from faculty and students also indicate the exigent need to introduce innovative components like games into curricula to achieve student engagement and promote a meaningful learning experience.
摘要：
游戏化正在成为医学教育中的一项主动学习创新，以提高学生的参与度，并在独特的协作环境中促进终身学习。生物化学中的临床酶学是医学课程的核心主题之一。然而,学生在理解和保留信息方面面临挑战。因此，CARD＆BoardGAmes在医学教育（CARBGAME）中被引入并评估了其在增强学习方面的有效性，应用程序,并通过游戏化背景保留临床酶学知识。这项混合方法研究涉及150名一年级本科医学生。比赛前,学生完成了临床酶学的预测试。后来，他们被分成25个小组，参加为生物化学酶学设计的棋盘游戏。学生们轮流掷骰子，回答游戏板上的问题，继续前进。第一支达到100并解决基于案例的问题的团队被认为是获胜者。在棋盘游戏之后，学生们参加了后测，以比较创新的教育影响。此外，随后的内部评估评分与未实施本干预的前一批比较.然后，学生使用5分Likert量表的32项问卷评估CABGAME-临床酶学的有效性。在10分评分表上获得的反馈，用于定性分析，学生和教师的看法被记录在小组中。CARBGAME收到了来自学生和教师的压倒性的积极反馈。学生们认为它很有趣，相关,一致,激励,协作,促进体验式学习。游戏的低风险方法，有效的反馈,成就感受到高度赞赏，使其成为教育的宝贵工具。记录了知识的显着改善，从比赛前20分得分的平均得分为8.37±1.126，到比赛后的16.53±1.219，p值为0.0001。干预组和非干预组学生之间的内部评估分数的比较也显示了使用CARBGAME的学生之间的显着改善（p<0.0001）。CARBGAME创新已实现了促进主动学习和增强临床酶学性能的预期结果。教师和学生的积极回应也表明迫切需要将游戏等创新组件引入课程，以实现学生的参与并促进有意义的学习体验。
