Interactive Ren'Py Learning in Physiotherapy Education

Digitalization Through the Use of Ren'Py-Based Interactive Learning Experiences in Physiotherapy and Rehabilitation Education: A Randomised, Controlled, Single-Blind Study

Advances in health professions education increasingly emphasize the use of digital technologies to enhance student engagement and support diverse learning needs. In physiotherapy training, particularly in technically complex subjects like electrotherapy, conventional instruction may fall short in fostering active learning and knowledge retention. Game-based platforms such as Ren'Py offer an opportunity to integrate interactive, scenario-based learning into the curriculum. This study aimed to assess the impact of Ren'Py-based digital materials on learning outcomes by comparing conventional, digital, and hybrid teaching models in an undergraduate electrotherapy course.

Study Overview

• Status: Completed
• Conditions: Student
• Intervention / Treatment: Other: Conventional Instructional Material; Other: Digital Instructional Material

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kozlu
    • Zonguldak, Kozlu, Turkey (Türkiye), 67000
      • Zonguldak Bülent Ecevit University, Facultu of Health Sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Voluntary participation
• Cumulative GPA above 1.80
• Access to a device compatible with at least one of the following operating systems or platforms: Linux x86_64/Arm, Windows 7 or later, or Mac OS X 10.10 or later

Exclusion Criteria:

• History of course failure due to absenteeism

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional Education; The course content was standardized using materials from the "CK4Stim-Clinical Key for Electrical Stimulation in Physiotherapy and Rehabilitation" project (CK4Stim, Access Date: October 2024). The CK4Stim project, supported by the European Union and involving multiple projects partners, aims to develop a common language for the use of electrical stimulation in physiotherapy and rehabilitation education in accordance with European standards.	Other: Conventional Instructional Material; The course content was standardized using materials from the "CK4Stim-Clinical Key for Electrical Stimulation in Physiotherapy and Rehabilitation" project (CK4Stim, Access Date: October 2024). The CK4Stim project, supported by the European Union and involving multiple projects partners, aims to develop a common language for the use of electrical stimulation in physiotherapy and rehabilitation education in accordance with European standards.
Experimental: Digital Education; A lesson package containing a story in an interactive visual novel format created using Ren'Py. This package was designed by the researchers to include the theoretical and practical contents of the medium frequency currents unit, again using the content of the CK4Stım project.	Other: Digital Instructional Material; A lesson package containing a story in an interactive visual novel format created using Ren'Py. This package was designed by the researchers to include the theoretical and practical contents of the medium frequency currents unit, again using the content of the CK4Stim project.
Other: Conventional and Digital Education; A group that received both educational models for comparison.	Other: Conventional Instructional Material; The course content was standardized using materials from the "CK4Stim-Clinical Key for Electrical Stimulation in Physiotherapy and Rehabilitation" project (CK4Stim, Access Date: October 2024). The CK4Stim project, supported by the European Union and involving multiple projects partners, aims to develop a common language for the use of electrical stimulation in physiotherapy and rehabilitation education in accordance with European standards.; Other: Digital Instructional Material; A lesson package containing a story in an interactive visual novel format created using Ren'Py. This package was designed by the researchers to include the theoretical and practical contents of the medium frequency currents unit, again using the content of the CK4Stim project.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Theoretical Knowledge Examination Score	A researcher-developed 20-item multiple-choice theoretical exam assessing students' knowledge of electrotherapy principles. Full Scale Name: Theoretical Knowledge Examination (20-item multiple-choice test) Score Range: 0 to 100 points Interpretation: Higher scores indicate better theoretical knowledge.	Measured at 1-week follow-up after completion of the educational intervention.
Practical Skills Examination Score	A 16-item practical performance assessment evaluated by an independent three-member exam jury. Each item was rated as "Sufficient", "Partial", or "Insufficient", and final scores were calculated as the arithmetic mean of the three jury evaluations, scaled to a 0-100 range. Full Scale Name: Practical Skills Performance Assessment (16-item jury-rated evaluation) Score Range: 0 to 100 points Interpretation: Higher scores indicate better practical performance.	Measured at 1-week follow-up after completion of the educational intervention.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive Load Rating Score	Subjective cognitive load was assessed using the nine-point Cognitive Load Rating Scale developed by Paas and Van Merriënboer (1993). Participants rated the level of mental effort experienced during the learning activity on a nine-point Likert-type scale. Full Scale Name: Paas & Van Merriënboer Cognitive Load Rating Scale (9-point Likert scale) Score Range: 1 (Very Low) to 9 (Very High) Interpretation: Higher scores indicate greater perceived cognitive load.	Measured at 1-week follow-up after completion of the educational intervention.
Instructional Materials Motivation Scale Score	Motivation toward the instructional materials was assessed using the 33-item Instructional Materials Motivation Scale (IMMS) developed by Keller. Participants rated each item on a five-point Likert scale evaluating attention, relevance, confidence, and satisfaction related to the instructional materials. Full Scale Name: Instructional Materials Motivation Scale (IMMS), 33-item Likert scale Score Range: 33 (minimum) to 165 (maximum) Interpretation: Higher scores indicate higher motivation toward the instructional materials.	Measured at 1-week follow-up after completion of the educational intervention.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Attitude Toward the Physiotherapy Profession Score	Attitudes toward the physiotherapy profession were measured using the Attitude Toward the Physiotherapy Profession Scale developed by Turhan. The scale contains 35 items rated on a five-point Likert scale and assesses three dimensions: professional satisfaction, required professional competencies, and general concerns regarding the profession. Full Scale Name: Attitude Toward the Physiotherapy Profession Scale (35-item Likert scale) Score Range: 35 (minimum) to 175 (maximum) Interpretation: Higher scores indicate more positive attitudes toward the physiotherapy profession.	Assessed at baseline (prior to the intervention) and again 1 week after completion of the intervention.

Collaborators and Investigators

• Sponsor: Ahmet Koçyiğit

Study record dates

Study Major Dates

• Study Start (Actual): October 7, 2024
• Primary Completion (Actual): December 13, 2024
• Study Completion (Actual): December 27, 2024

Study Registration Dates

• First Submitted: November 19, 2025
• First Submitted That Met QC Criteria: November 27, 2025
• First Posted (Actual): December 10, 2025

Study Record Updates

• Last Update Posted (Actual): December 10, 2025
• Last Update Submitted That Met QC Criteria: November 27, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 03.07.2024/468499; https://osf.io/38ntm (Other Identifier: Open Science Framework)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Anonymized data and software repositories will be shared on OSF.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No