Impact of Gamification as Compared to Conventional Teaching Methods Among Dental Students in Egypt

Impact of Gamification Compared to Conventional Teaching Among Dental Students in Egypt: A Crossover Controlled Trial

This study is designed to evaluate the effect of gamification-based teaching strategies on learning outcomes and student engagement in undergraduate oral pathology education. Traditional didactic teaching methods in dental education are often associated with passive learning and variable student engagement. In response, educational gamification has emerged as an innovative pedagogical approach that integrates game elements into learning activities to enhance motivation, participation, and knowledge retention.

This study employs a crossover interventional design involving undergraduate dental students enrolled in an Oral Pathology course. Participants will be exposed to both traditional teaching methods and gamified learning interventions in a structured sequence, allowing each participant to serve as their own control. The gamified intervention includes the use of an online game designed on Genially to reinforce key concepts in Oral Pathology. The traditional control arm consists of standard lecture-based instruction without gamification elements.

The primary objective of this study is to compare knowledge acquisition between gamified and traditional teaching approaches, measured through standardized assessments administered after each intervention phase. Secondary objectives include evaluating student engagement, satisfaction, and perception of learning effectiveness using validated structured questionnaires.

The study aims to determine whether gamification enhances academic performance and improves student engagement compared to conventional teaching methods. It also seeks to explore student perceptions of innovative teaching strategies and their potential integration into the dental curriculum.

Data will be collected at multiple time points corresponding to each phase of the crossover design. Statistical analysis will compare outcomes between intervention periods, accounting for within-subject variability. The findings are expected to provide evidence-based insights into the effectiveness of gamification in dental education and support curriculum development strategies aimed at improving active learning and student-centered teaching approaches.

This study addresses an important gap in dental education research by systematically evaluating gamification using a controlled crossover design, providing robust comparative data between traditional and innovative teaching methods in oral pathology education.

Study Overview

• Status: Completed
• Conditions: Gamification in Oral Pathology Education
• Intervention / Treatment: Behavioral: Gamification-based Teaching; Behavioral: Traditional Lecture-based Teaching

Detailed Description

This study evaluates the effect of gamification-based teaching strategies on learning outcomes and student engagement in undergraduate Oral Pathology education. Traditional lecture-based teaching in dental curricula is widely used; however, it is often associated with passive learning, limited interaction, and variable student engagement. In contrast, gamification integrates game design elements into educational activities to enhance motivation, participation, and active learning.

Study Design Randomized controlled crossover experimental design to compare a gamified learning intervention with a traditional revision approach. This design allows each participant to act as their own control, thereby minimizing inter-individual variability and strengthening internal validity.

Study Setting and Participants The study is conducted among third-year dental students enrolled in the Oral Pathology course, Faculty of Dentistry, Pharos University in Alexandria during spring semester of the academic year 2026. Participants are informed about the study objectives, and a written informed consent is obtained prior to their inclusion.

Data Collection Data collection was carried out during the period from February to April 2026. The data is collected via Google Forms, through face-to-face sessions, or during scheduled tutorials under standardized conditions to ensure consistency and reliability of responses.

Data Collection Tools

1. Demographic Questionnaire: The demographic questionnaire is developed to collect age, gender, cumulative GPA, secondary school education and parental educational level.
2. Learning Style Inventory: The validated VARK questionnaire (Version 9.0) is used to categorize students' learning preferences
3. Gamified Learning Tool: Two custom-designed digital games are designed on Genially(reference). To reduce content related confounding and to enhance the reliability of comparisons across the two intervention phases, a single Oral Pathology topic "White Lesions of the Oral Cavity" is selected for the study. The topic is deliberately divided into two equivalent parts: White Lesions-Part I (WL1) and White Lesions- Part II (WL2), each covering distinct but comparable subtopics with similar learning objectives and cognitive demands.
4. Traditional Revision Session: Standardized PowerPoint slides and instructor-led case discussions covering the same content and learning objectives as the interventional session.
5. Knowledge Assessment Tests: Four parallel, pre-validated versions of a test consisting of 10 Multiple-Choice Questions; including 2 pre-tests (WL1 and WL2) and 2 post-tests (WL1 and WL2).
6. Satisfaction and Engagement Survey: A mixed-methods survey incorporating a 5-point Likert scale to quantify enjoyment, perceived learning, and engagement, adapted from the DREEM framework is used.
7. Focus Groups: Focus groups with a selected number of students (e.g. 20 students) to collect detailed qualitative feedback and further ideas for improvement.

Data Collection Procedures Week 0 (Baseline): Informed consent, demographic questionnaire, and VARK inventory. Cluster Randomization: Participants are randomly assigned to Group A or Group B.

• Week 1 (Phase I) Group A (Intervention): Pre-test → Game → Immediate Post-test on WL1. Group B (Control): Pre-test → Traditional Revision → Immediate Post-test on topic WL1.
• Week 3 (Phase II) - Groups cross over and repeat the process with WL2. Group B (Intervention): Pre-test → Game → Immediate Post-test on WL2.

Group A (Control): Pre-test → Traditional Revision → Immediate Post-test on topic WL2.

• Week 5 All participants complete a comprehensive delayed post-test on WL1 to assess long-term retention.
• Week 7 All participants complete a comprehensive delayed post-test on WL2 to assess long-term retention.

All participants complete the Satisfaction and Engagement Survey. A selected number of students are included in focus groups to collect qualitative feedback.

Data Analysis Data is analyzed using SPSS (Version 28). A p-value < 0.05 is considered significant.

1. Descriptive statistics for demographics.
2. A mixed-model repeated measures ANOVA will be used to analyze knowledge scores, accounting for the crossover design(21).
3. Satisfaction/Engagement: Mann-Whitney U tests will compare satisfaction scores. Qualitative feedback will be analyzed using thematic analysis.
4. Moderating Role of Learning Styles: An interaction term (Learning Style * Intervention Type) will be added to the ANOVA model to test for moderation.
5. Gender, cumulative GPA, socio-cultural status, parental educational level, and school education will be included as covariates in the primary analysis (ANCOVA).

• Study Type: Interventional
• Enrollment (Actual): 168
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Alexandria, Egypt
    • Pharos University in Alexandria

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

All third-year students enrolled in the Oral Pathology course during the Spring semester, 2026.

Exclusion Criteria:

1. Students with previous exposure to the course will be excluded from the study; those who have previously taken the course and failed the exam, or those who are retaking the course to improve their grade.
2. Students who haven't completed General Pathology, General Histology or Oral Biology courses will be excluded from the study.
3. Students with learning difficulties- as determined by Special Cases Coordinator in the faculty- such as dyslexic or bipolar students will be excluded from the current study.
4. Students who were absent during one or more of the intervention sessions.
5. Students who did not consent to participate in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Gamification Sequence; Participants in this arm receive gamification-based teaching in the first phase of the study, followed by traditional lecture-based instruction in the second phase after cross-over. The gamified intervention included a digital game, created on Genially to enhance knowledge acquisition, retention and student engagement.	Behavioral: Gamification-based Teaching; Two custom-designed digital games will be designed on Genially(reference). To reduce content-related confounding and to enhance the reliability of comparisons across the two intervention phases, a single Oral Pathology topic was selected for the study. The topic was deliberately divided into two equivalent parts, each covering distinct but comparable subtopics with similar learning objectives and cognitive demands. Educational Principles Incorporated; Retrieval Practice: The game emphasizes active retrieval of information through repeated questioning and case-based challenges.; Spaced Repetition: Core Oral Pathology concepts are revisited across multiple stages of gameplay.; Scaffolding (Progressive Difficulty): Game levels are structured to progress from simple to complex cognitive demands. This progressive structure aimed to support cognitive load management and facilitate deeper learning.; Feedback: Immediate feedback is provided after each response.; Behavioral: Traditional Lecture-based Teaching; Conventional teaching method used in Oral Pathology education, consisting of structured instructor-led lectures and standard PowerPoint presentations without gamification elements. The teaching is delivered in a passive learning format focusing on theoretical explanation of Oral Pathology concepts.
Active Comparator: Traditional Sequence; Participants in this arm receive traditional lecture-based teaching in the first phase of the study, followed by gamification-based teaching in the second phase after the cross-over. The traditional teaching method consists of standard PowerPoint lectures, without game-based elements.	Behavioral: Gamification-based Teaching; Two custom-designed digital games will be designed on Genially(reference). To reduce content-related confounding and to enhance the reliability of comparisons across the two intervention phases, a single Oral Pathology topic was selected for the study. The topic was deliberately divided into two equivalent parts, each covering distinct but comparable subtopics with similar learning objectives and cognitive demands. Educational Principles Incorporated; Retrieval Practice: The game emphasizes active retrieval of information through repeated questioning and case-based challenges.; Spaced Repetition: Core Oral Pathology concepts are revisited across multiple stages of gameplay.; Scaffolding (Progressive Difficulty): Game levels are structured to progress from simple to complex cognitive demands. This progressive structure aimed to support cognitive load management and facilitate deeper learning.; Feedback: Immediate feedback is provided after each response.; Behavioral: Traditional Lecture-based Teaching; Conventional teaching method used in Oral Pathology education, consisting of structured instructor-led lectures and standard PowerPoint presentations without gamification elements. The teaching is delivered in a passive learning format focusing on theoretical explanation of Oral Pathology concepts.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knowledge Acquisition	Assessment of student knowledge acquisition following each teaching phase (gamification-based and traditional lecture-based instruction). Knowledge is measured using a standardized assessment, consisting of 10 multiple-choice questions (1 point each). On a scale of 0-10, students were given scores, with 10 representing the best scores. Scores are compared before (pre-test) and immediately after (immediate post-test) the intervention. Scores are also compared between intervention phases in a cross-over design, where each participant serves as their own control.	Week (1) and Week (3): Immediately after the completion of each teaching phase (gamification phase and traditional teaching phase).
Long-term retention	Assessment of student knowledge retention, four weeks after the teaching phase (Gamification-based and Traditional lecture-based instruction). Knowledge is measured using a standardized assessment consisting of 10 multiple-choice questions (1 point each). On a scale of 0-10, students were given scores, with 10 representing the best scores. Scores are compared before the intervention (pre-test) and 4-weeks after the intervention (delayed post-test). Scores are also compared between intervention phases in a cross-over design, where each participant serves as their own control.	Week (5) and week (7): 4 weeks after the teaching phase

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Student Satisfaction and Engagement	Evaluation of student satisfaction and level of engagement during each teaching method, using a validated Likert-scale questionnaire, on a scale of 0-4 (with 0 representing least satisfied and 4 representing most satisfied). The structured questionnaire is adapted from the DREEM questionnaire and assesses engagement, enjoyment and perceived learning during the gamification phase.	Week (7): After completion of all phases of the intervention

Collaborators and Investigators

• Sponsor: Pharos University in Alexandria

Study record dates

Study Major Dates

• Study Start (Actual): February 12, 2026
• Primary Completion (Actual): April 9, 2026
• Study Completion (Actual): April 16, 2026

Study Registration Dates

• First Submitted: April 19, 2026
• First Submitted That Met QC Criteria: April 25, 2026
• First Posted (Actual): May 4, 2026

Study Record Updates

• Last Update Posted (Actual): May 19, 2026
• Last Update Submitted That Met QC Criteria: May 17, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Educational Intervention; Gamification; Cross-over; Dental Education; Oral Pathology; Undergraduate Dental Students
• Other Study ID Numbers: PUA-0220260163462

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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