An Exploratory Digital Board Game Approach to the Review and Reinforcement of Complex Medical Subjects Like Anatomical Education: Cross-sectional and Mixed Methods Study

Abstract

Background: Serious games have the potential to resolve educational problems faced by medical students, such as insufficient rehearsal due to boredom and lack of motivation. However, serious games' relatively novel concepts in science and many genres of games that are common in recreation remain underresearched in the literature. Board games are one such genre that, despite their potential, affordability, and flexibility, are rarely designed for medical students, and little is known about student perceptions of them and their compatibility with rehearsal.

Objective: In this cross-sectional study, we sought to elicit, via an exploratory mixed methods approach, student perceptions of a digital serious board game specifically designed for the gamified rehearsal of complex medical subjects, with the chosen topic of anatomy.

Methods: A digital serious board game, based on self-determination theory (SDT), was first designed and developed to facilitate the rehearsal of anatomy information. Students were then voluntarily recruited to partake in the intervention and were randomly split into three teams of 2 players per game session, after which they were administered the Flow Short Scale (FSS), which is a 13-item measure where items were rated on a 7-point Likert scale ranging from 1 ("not at all") to 7 ("very much"). Students then participated in a focus group discussion to elicit their perceptions of the game. Findings from the FSS were subject to descriptive analysis, and the focus group discussion was subject to inductive thematic analysis.

Results: A total of 12 undergraduate, second-year medical students from the Lee Kong Chian School of Medicine in Singapore participated in the study. FSS results indicated a moderate level of overall flow (mean score 4.94, SD 1.07) via the subdomains of fluency (mean score 4.77, SD 1.13) and absorption (mean score 5.21, SD 1.1). Students perceived the game as fun, enjoyable, engaging, and appropriate as a rehearsal tool that alleviated the monotony of traditional methods of rehearsal.

Conclusions: Our digital board game-based rehearsal tool, when based on SDT, appeared to be suitable for gamified rehearsal in a fun and enjoyable environment due to its facilitation of intrinsic motivation in its players.

Keywords: anatomy; board games; flow; serious games.

Figure 1

Self-determination theory as defined by, and adapted from, the works of Deci and Ryan [50,51]. The fulfilling of the three needs of competence, autonomy, and relatedness results in the promotion of internally regulated sources of motivation and, resultantly, an intrinsic desire to partake in the game activity.

Figure 2

Overview of the game board and all elements therein. Only one copy of each team’s unit is featured, due to a duplicate function that allows for easy "copying and pasting" of any item on the board.

Figure 3

Close-ups of each team’s functionally identical but cosmetically distinct units. All units were equipped with colored bases for ease of locating when the camera was raised high above the game board.

Figure 4

Question cards are shown, which are comprised two types of questions: (A) multiple-choice questions and (B) open-ended questions requiring students to specify short answers.

Figure 5

Overview of the mixed methods study design, wherein collection of quantitative data comprised the Flow Short Scale and qualitative data was comprised of transcriptions from the focus group discussions.