BACKGROUND: While game-based learning has demonstrated positive outcomes for some learners, its efficacy remains variable. Adaptive scaffolding may improve performance and self-regulation during training by optimizing cognitive load. Informed by cognitive load theory, this study investigates whether adaptive scaffolding based on interaction trace data influences learning performance, self-regulation, cognitive load, test performance, and engagement in a medical emergency game.
METHODS: Sixty-two medical students from three Dutch universities played six game scenarios. They received either adaptive or nonadaptive scaffolding in a randomized double-blinded matched pairs yoked control design. During gameplay, we measured learning performance (accuracy, speed, systematicity), self-regulation (self-monitoring, help-seeking), and cognitive load. Test performance was assessed in a live scenario assessment at 2- and 6-12-week intervals. Engagement was measured after completing all game scenarios.
RESULTS: Surprisingly, the results unveiled no discernible differences between the groups experiencing adaptive and nonadaptive scaffolding. This finding is attributed to the unexpected alignment between the nonadaptive scaffolding and the needs of the participants in 64.9% of the scenarios, resulting in coincidentally tailored scaffolding. Exploratory analyses suggest that, compared to nontailored scaffolding, tailored scaffolding improved speed, reduced self-regulation, and lowered cognitive load. No differences in test performance or engagement were found.
CONCLUSIONS: Our results suggest adaptive scaffolding may enhance learning by optimizing cognitive load. These findings underscore the potential of adaptive scaffolding within GBL environments, cultivating a more tailored and effective learning experience. To leverage this potential effectively, researchers, educators, and developers are recommended to collaborate from the outset of designing adaptive GBL or computer-based simulation experiences. This collaborative approach facilitates the establishment of reliable performance indicators and enables the design of suitable, preferably real-time, scaffolding interventions. Future research should confirm the effects of adaptive scaffolding on self-regulation and learning, taking care to avoid unintended tailored scaffolding in the research design.
BACKGROUND: This study was preregistered with the Center for Open Science prior to data collection. The registry may be found at https://osf.io/7ztws/ .

Description of the Problem. Gamification is used in pharmacy education as an innovative learning strategy to engage learners with educational content. The March Medication Madness activity used bracketology, a type of gamification not previously described in pharmacy education literature, to increase student engagement and knowledge of key disease states. The Innovation. The activity was developed for use in a capstone course during the final semester of the didactic pharmacy curriculum. Students created medication-related pearls that were placed in a tournament-style bracket. Students then completed brackets to predict the winning pearls and voted biweekly to determine the most clinically significant pearl. Student knowledge was assessed pre- and post-activity along with a post-activity perception assessment. Critical Analysis. Of the 52 student participant responses, most agreed or strongly agreed that the activity increased understanding and stimulated interest in course material, while adding a fun element to the course. There was a statistically significant increase (P = .002) in the average percentage of multiple-choice questions students answered correctly from the pre-test (57.7% ± 1.5%) to the posttest (63.1% ± 1.9%). Pearls that received the most votes were no more likely to be associated with an increase in knowledge than pearls receiving fewer votes. Next Steps. Implementation of a bracketology activity was perceived by students as fun, engaging, and beneficial in understanding course material. However, increase in knowledge was limited. This shows the importance of structuring gamification in a way that provides educational value and underscores the need to modify the activity to promote student learning.

BACKGROUND: The increasing complexity of the healthcare environment and the necessity of multidisciplinary teamwork have highlighted the importance of interprofessional education (IPE). IPE aims to enhance the quality of patient care through collaborative education involving various healthcare professionals, such as doctors, nurses, and pharmacists. This study sought to analyze how game-based IPE activities influence students\' perceptions and reflective thinking. It also aimed to identify the shifts in perception and effectiveness caused by this educational approach.
METHODS: The study is based on a game-based IPE program conducted at University A, involving medical and nursing students in structured learning and team-based activities. Data were collected using essays written by the students after they had participated in IPE activities. Text network analysis was conducted by extracting key terms, performing centrality analysis, and visualizing topic modeling to identify changes in students\' perceptions and reflective thinking.
RESULTS: Keywords such as \"patient,\" \"thought,\" \"group,\" \"doctor,\" \"nurse,\" and \"communication\" played a crucial role in the network, indicating that students prioritized enhancing their communication and problem-solving skills within the educational environment. The topic modeling results identified three main topics, each demonstrating the positive influence of game-based collaborative activities, interprofessional perspectives, and interdisciplinary educational experiences on students. Topic 3 (interdisciplinary educational experience) acted as a significant mediator connecting Topic 1 (game-based collaborative activity experience) and Topic 2 (interprofessional perspectives).
CONCLUSIONS: This study demonstrates that game-based IPE activities are an effective educational approach for enhancing students\' team building skills, particularly communication and interprofessional perspectives. Based on these findings, future IPE programs should focus on creating collaborative learning environments, strengthening communication skills, and promoting interdisciplinary education. The findings provide essential insights for educational designers and medical educators to enhance the effectiveness of IPE programs. Future research should assess the long-term impacts of game-based IPE on clinical practice, patient outcomes, and participants\' professional development.

BACKGROUND: The study explores the significance of continuous improvement through Kaizen in the evolving landscape of anatomy education. In this study, our objectives were twofold: 1) to assess the effectiveness of incorporating games in the first-year medical curriculum for reinforcing anatomy knowledge, and 2) to explore whether game-based sessions elicit improved student responses in the learning of anatomy.
METHODS: A total of 100 first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) students at All India Institute of Medical Sciences (AIIMS), Bibinagar, Hyderabad, Telangana, India, were exposed to game-based learning which involved six rounds: acronym mnemonics (Redolent), jigsaw puzzle solving (Dumbfound), Filling gaps in concept maps (Blogging), Connecting images (Kinship), case scenario creation (Penman), and rapid-fire round (Rattling).
RESULTS: At the end of the intervention, a test was taken and feedback was obtained from all the participants using a prevalidated questionnaire prepared based on a 5-point Likert scale. Questionnaire responses were subjected to descriptive analysis, and reliability analysis (Cronbach\'s α) was performed to evaluate the internal consistencies of items. A paired t-test indicated that there was a significantly large difference between before (mean (M) = 17.2, standard deviation (SD) = 9.1) and after (M = 25.9, SD = 8), t(99) = 18.4, p < .001, signifying that the performance of the students was far better with game-based learning approaches than conventional learning.
CONCLUSIONS: Combining game-based education with Kaizen principles in anatomy education not only prepares students for success in their academic pursuits but also empowers them to navigate the complexities of the ever-evolving healthcare landscape with confidence and proficiency.

The effectiveness of game-based learning strategies lies in the ability of these strategies to engage learners and enhance their motivation to learn. This is particularly important for today\'s younger generations, which are known to respond better to visual rather than textual information. Gamified education provides stimulating, realistic, and enjoyable learning experiences, helping students understand complex nursing knowledge and skills. The diversity of game-based learning tools, including based board games, escape room games, digital games, simulation games, mobile serious games, and virtual reality games, not only enhances students\' learning effectiveness and skills but also improves their problem-solving abilities, communication skills, and ability to cope with various challenges in clinical care. In general, game-based learning is a strategy with great potential and importance. This strategy not only has profound implications for modern nursing education and clinical practice but also, through its promotion of innovative thinking and diversified applications, can effectively promote the learning motivation of nursing professionals, improve teaching effectiveness, and enhance professional abilities and self-directed learning capabilities. In an era in which medical knowledge is constantly evolving, game-based learning should be promoted and utilized to cultivate nursing professionals\' capabilities effectively.
BACKGROUND: 悅趣化教學之多元化發展與臨床運用.
悅趣化學習是一個具有潛力和重要性的教學策略，對於現代護理教育和臨床實務具有深遠的影響，透過悅趣化教學的創新思維和多元化應用，可以促進學生的學習動機，提高教學效果，並有效培養護理人員的專業能力和自主學習能力。悅趣化學習策略的有效性在於其能夠吸引學習者並提升其學習動機，這對於現今偏好視覺性資訊的年輕世代尤其重要，悅趣化教學通過提供刺激性、真實性和樂趣性的學習體驗，有助於護理人員理解複雜的護理知識與技能。悅趣化教學具有多樣性，包括桌上型遊戲、密室逃脫遊戲、數位互動教學工具、模擬遊戲、行動嚴肅遊戲和虛擬實境遊戲等，這些工具不僅可以增強學生的學習成效和技能，還能夠提升其問題解決能力、溝通技巧，並幫助他們應對臨床照護中的各種挑戰。.

With the recent rapid changes in the medical environment and technology, traditional teaching methods are no longer sufficient to meet current professional needs. There is an increasing demand for emerging technologies in higher education, necessitating more interactive and personalized educational approaches. Hence, educators are exploring innovative teaching interventions, including digital simulations and gamified learning, to enhance motivation and engagement in learning. In this article, the concept and core elements of gamified learning are introduced and related methods applicable to nursing education such as digital simulations, virtual reality, tabletop games, and escape rooms are described. In addition, gamification teaching techniques that enhance student learning motivation as well as improve learning outcomes in theory and practice are discussed. Gamified learning enables nursing students to practice in rich and diverse interactive simulated environments. Using appropriate teaching strategies, the gamified approach to learning can strengthen critical thinking, problem-solving abilities, and communication confidence in students. Designing game mechanisms and methods that align with educational objectives and mastering the key principles of gamified teaching is an effective approach to diversifying and enhancing the effectiveness of learning activities in the classroom.
BACKGROUND: 遊戲化教學運用在護理教育.
隨著醫療環境與技術的迅速變遷，傳統教學模式已不足以滿足當前的專業需求，高等教育中對新興技術的需求日益增加，迫切需要更互動性和個性化的教育模式。是以教學上探索著包括數位模擬和遊戲化學習在內的創新教學介入方法，以提升學習動機和參與度。本文介紹遊戲化學習的概念和核心元素，列舉運用於護理教學包括數位模擬、虛擬實境、桌上遊戲以及密室逃脫等方式，以及遊戲化教學技巧，這些策略不僅增強學生的學習動機，也提升了理論與實務技能的學習效果。遊戲化學習使護理學生能在豐富且多元互動的模擬環境中練習，搭配合宜教學的策略安排，能夠強化學生的批判性思考、問題解決能力和溝通的信心。設計能符合教學目標的遊戲機制與方法，掌握遊戲化教學的關鍵原則，讓教室裡的學習活動多樣貌與具效益。.

UNASSIGNED: The purpose of this study was to examine the perspectives of English as a Foreign Language Special Education teachers (EFLSE) regarding game-based learning approaches for addressing behavioral disorders in ADHD patients.
UNASSIGNED: The study involved a sample (n = 131) of EFLSE teachers who completed a questionnaire to determine how feasible, acceptable, and helpful they found game-based learning.
UNASSIGNED: The study revealed that EFLSE teachers perceive game-based learning to be a feasible and acceptable method for engaging ADHD students and helping to maintain their attention during game-based learning activities. Nevertheless, implementation and individualized approaches are cited as challenges. Additionally, EFLSE teachers emphasized the benefits of game-based learning, including improved problem-solving, assessment methods, collaboration, and the acquisition of academic skills.
UNASSIGNED: The study contributes insights for educators, policymakers, and researchers that can support the development of evidence-based interventions offering game-based learning for students with ADHD.

UNASSIGNED: Game-Based Learning (GBL) is an innovative pedagogical approach that utilizes digital applications to enhance health sciences higher education. Therefore, analyzing faculty and students\' perspectives on GBL can help educational administrators, educators, and researchers tailor GBL to students\' needs.
UNASSIGNED: This study aimed to explore faculty (teachers) and students\' perspectives towards GBL in health sciences higher education. Further to identify barriers affecting the use of GBL as well as recommendations for its use from their perspectives.
UNASSIGNED: A descriptive-qualitative approach was conducted at a Saudi university. A total of 42 semi-structured interviews were completed with a purposive sampling of 22 faculty members and 20 students until data saturation. The data were analyzed using a thematic content analysis approach.
UNASSIGNED: Faculty members and students reflected on their personal experiences using GBL, and the data presented seven themes and 30 categories emerged from the content analysis: common digital apps, purpose and uses, effect or benefits of GBL, personal experience with GBL, challenges and barriers affecting the use of digital games, and recommendations for educators on using GBL apps.
UNASSIGNED: The experiences of both students and faculty demonstrated that GBL can enhance classroom learning and complement traditional teaching approaches in health sciences higher education. GBL\'s safe, immersive environment lets students practice many generic skills, boosting interest, motivation, and peer-mediated learning. Faculty and students shared their GBL experiences, responsibilities, and enthusiasm. Health sciences higher education institutions should consider ways to increase flexibility in providing resources and training to educators who want to build and use the GBL approach in their classroom.

Research coursework can be challenging for occupational therapy students, thus potentially compromising their engagement in learning. A student engagement framework was used to design and implement an innovative assignment called Researchers\' Theater with a cohort of 38 first-semester occupational therapy students. At the beginning of each class, a small group of students led a creative activity to review topics from the preceding week. Student feedback survey results and instructors\' observations suggest this framework contributed to students\' affective, behavioral, and cognitive engagement. Findings also highlight the potential value of student-led, game-based learning for reinforcing course content.

UNASSIGNED: High-stakes yet clinically infrequent procedures are challenging to teach. Escape rooms may offer an innovative solution through game-based learning. There is limited guidance on how to design an escape room focused on physical puzzles. We designed and implemented a procedure-focused escape room to teach high-stakes procedures to anesthesiology residents.
UNASSIGNED: We selected 5 procedural skills relevant to anesthesiology residents through a modified Delphi technique: fiberoptic intubation, rapid infuser setup, intraosseous line placement, flexible bronchoscopy, and supraglottic airway exchange. We designed associated skills stations and linked them in sequence using an elaborate series of puzzles, locks, keys, and codes. The total cost of puzzle equipment was $169.53. After pilot testing, we implemented the escape room from July to November 2022. We assessed residents using a single group pretest-posttest study design.
UNASSIGNED: Forty-three of 55 (78%) eligible anesthesiology residents participated in the escape room. Thirty-one residents completed the surveys. Resident self-efficacy significantly improved for each of the 5 procedures. Twenty-six of 27 (96%) residents preferred the escape room over a typical procedural skills workshop.
UNASSIGNED: This pilot study demonstrated the feasibility of a procedure-focused escape room for teaching high-stakes technical skills. We identified 3 lessons in procedure-focused escape room design: set participant caps intentionally, optimize resource usage, and maximize reproducibility. Participating in a single escape room session significantly increased resident self-efficacy. Residents strongly preferred the escape room format over a traditional procedural skills workshop.