Enhancing medical student engagement in public health content using gamification: key findings and future considerations

Public health education is a core and vital competency in medical curricula; however, evidence indicates student interest, enjoyment and engagement in public health content during medical school is low.  New and emerging health challenges pose a real-life threat to the prosperity of all worldwide, consequently, having a knowledge and understanding of public health is critical to help ensure the medical workforce is appropriately equipped to deal with these in a suitable manner. As a lecturer who teaches public health in a medical program, I was interested in exploring ways to enhance engagement in public health content amongst this cohort of students. Here is what I did, what I found, and future considerations should this be something other educators wish to explore. 

The incorporation of gamification for public health content in medical curricula  

Gamification focuses on incorporating games or gaming elements in teaching to maximise student enjoyment, engagement and learning. Evidence suggests gamification of educational content can enhance levels of student engagement and optimise student learning. As such, I incorporated the use of games and gaming elements into my public health teaching, specifically in small group workshops (comprising approximately 100 students) where students are encouraged to unpack and apply key ideas and concepts. To ensure constructive alignment, all games were informed by session learning outcomes and reviewed by educational experts (e.g., Learning Designers). Further, to help ensure variety, together with supporting diverse learning styles, I utilised several different game types and formats from quizzes, to online games, to puzzle-based games. Games were scaffolded to allow students to explore, build on, and/or test their knowledge and understanding of key public health concepts. For example, to help students understand the role of social support in health, they were asked to navigate through a medical online simulation documenting how social support, or lack thereof, could influence a patient’s health and consequent outcomes. To help understand a patient’s journey through the healthcare system, students were required to solve a real-life medical case using medical documentation. Using a public health lens, students were then asked to interrogate the journey to identify challenges using these to develop a feasible solution to help remedy the problem. These solutions were then presented in a five-minute elevator pitch with a prize for the winning group. Further, to help embed qualitative research concepts, students engaged in a game of bingo (students were required to link concept descriptions to concepts they had assigned on their bingo card, the first to call bingo then won a prize).  Furthermore, I utilised quizzes to help test students’ knowledge using a variety of online platforms (e.g., Kahoot). 

Key findings 

Following the implementation of the gamification approach, students participated in focus groups to share their experiences. Overall, using gamification to help enhance engagement in public health content was received positively and enjoyed by students. It was noted that gamification helped enhance engagement in learning, made content more memorable, helped consolidate knowledge and streamline thinking. Further, students commented that it helped provide a sense of involvement in class and elicit discussion with peers and staff. However, students did outline specific gamification preferences. Whilst students saw the value in problem-solving-based games (e.g., mapping the patient journey), these types of games were only deemed meaningful when they were supported by teaching staff who could help facilitate and support discussion. Ultimately, students preferred quiz-based activities (for example, Kahoot or H5P ‘The Chase’) as these types of activities closely mimicked their formal assessment style of multiple-choice questions (MCQs), and as such, acted as a helpful revision tool.  Furthermore, students commented on how they would like gamification to be implemented in the MD program moving forward, noting the use of artificial intelligence (AI), with preferences leaning towards the integration of AI bots, specifically around being able to generate MCQs they could use to practise for their MCQ-based examinations. 

Future considerations 

Incorporating the use of games to assist in the teaching of public health content in a medical program can be beneficial for student learning and engagement in the course content. However, for beneficial outcomes to be observed, it is important to address several considerations. In the first instance, be mindful of students’ assessment tasks. During this work, students best engaged in game-based activities that provided them with real-time practice for their formative assessments. As such, it may be helpful to design in-class games that align with student assessment tasks. Not only does this help encourage engagement in content, but it may also help provide an opportunity for students to build key skills in different assessment formats (e.g., multiple-choice quizzes allow students to become familiar with question/answer assessment formats). Further, it is worthwhile considering teaching capacity when designing and implementing game-based activities that require students to engage in discussions to help them solve puzzles and/or tasks. Having capacity to both facilitate and support student discussions may help strengthen student confidence in practising and utilising problem-solving skills, skills which will be integral for their future medical practice. 

In conclusion 

Beyond the immediate enjoyment that gamifying content can provide, broader benefits of implementing such approaches exist, and have the potential to benefit students long after the class ends. Not only can such approaches help embed key concepts, but gamification may also act as a mechanism to foster key skills which may help enhance the ways in which students go on to practise medicine. As such, for educators working in medical education, thinking about adopting such approaches may be a worthwhile pursuit.