Using online game-based platforms to improve student performance and engagement in histology teaching

Abstract

Background: Human morphology is a critical component of dental and medical graduate training. Innovations in basic science teaching methods are needed to keep up with an ever-changing landscape of technology. The purpose of this study was to investigate whether students in a medical and dental histology course would have better grades if they used gaming software Kahoot® and whether gamification effects on learning and enjoyment.

Methods: In an effort to both evoke students' interest and expand their skill retention, an online competition using Kahoot® was implemented for first-year students in 2018 (n = 215) at the University of Eastern Finland. Additionally, closed (160/215) or open-ended (41/215) feedback questions were collected and analyzed.

Results: The Kahoot® gamification program was successful and resulted in learning gains. The overall participant satisfaction using Kahoot® was high, with students (124/160) indicating that gamification increased their motivation to learn. The gaming approach seemed to enable the students to overcome individual difficulties (139/160) and to set up collaboration (107/160); furthermore, gamification promoted interest (109/160), and the respondents found the immediate feedback from senior professionals to be positive (146/160). In the open-ended survey, the students (23/41) viewed collaborative team- and gamification-based learning positively.

Conclusion: This study lends support to the use of gamification in the teaching of histology and may provide a foundation for designing a gamification-integrated curriculum across healthcare disciplines.

Keywords: Collaborative learning; Dental education; Game design; Histology education; Knowledge retention; Medical education; Whole-slide imaging platform.

Conflict of interest statement

The authors declare that they have no competing interests in this section.

Figures

Fig. 1

Screenshot of a question and the digital learning scenario. a High-quality histological images were used with list of alternative answers to test morphological knowledge as well as correlation with function. Players answered the questions with their own mobile devices, while the questions and the time allocated to answering (red asterisk) were displayed on large shared screens. b The rooms for teaching sessions have been set up to move histology education into digital scenarios to help students’ active exchange of histology knowledge, as big touchscreens offered possibilities for teamwork in both years analyzed

Fig. 2

Summary of voluntary and anonymous responses on the student feedback forms. The survey represented a snapshot of a single educational event with a relatively large number (160) of attendees. Each person answered one of four levels of agreement or disagreement with the questions raised. Each panel of the plot shows a breakdown of the respondents into categories defined by the criteria listed below in the figure. The results of the survey indicated that the participants’ self-confidence improved with the introduction of gamification, and the students reported that the Kahoot® platform facilitated their ability to learn the course material in a more informal scenario. There was a positive association between the Kahoot® platform and the standardized mastery of the course material, as most of the students who used the platform felt that they had learned the material more comprehensively. Answers were collected by Kahoot® using a four-point Likert scale (1 = never, 2 = sometimes, 3 = often, 4 = always). Results are expressed as means, SD. Cronbach’s alpha coefficients obtained from analysis of questionnaires completed by medical and dental students of University of Eastern Finland was acceptable level coefficient of reliability for question number as follows: yellow bars (Alpha> 0.65): reasonable; green bars: satisfactory (Alpha < 0.65); red bar: unacceptable (Alpha < 0.5). Abbreviations:Q1:Did you read, printed materials related to topic during the course before each session?Q2:Gamification is an effective method for learning the basics of Histology.Q3:Gamification motivates me to learn more about morphology.Q4:The ability to collaborate with teachers during laboratory session via discussion of the game results was important.Q5:Kahoot enhances my understanding on the subjectsQ6:Gamification helps to retain my knowledgeQ7:The discussions during online game sessions improved my understanding of my skills.Q8:Gamification is an effective method to correct my misconception on the contentQ9:I am feeling nervous if I play an online game during laboratory sessionQ10:The Kahoot is a better platform than other e-learning platformsQ11:I am feeling relaxed if I play an online game during laboratory session.Q12:I’m more engaged with feedback through online gamification

Fig. 3

The exam grades earned in 2017 and in 2018 by groups and gender. Displays the exam score averages of different populations of students. A total of 418 students took the written examinations; 203 did so in 2017, and 215 participated in 2018. Introducing gamification into the histology curriculum for the medical and dental population caused a dramatic shift in the distribution frequencies of excellent grades according to odds. The student of 2018 academic year who received gamification based histology education, increased in odds were recorded as compared with students from 2017

Fig. 4

The topic-relevant online quiz performance of students in different gamification scenarios. Experimental groups: online quiz played at the beginning of teaching sessions by an individual player (GI) or a team (G II), quiz played at the end of teaching session by an individual player (G III) or a team (G IV), and quiz played twice, at the beginning and the end of class, by a team (G V). The first-year medical and dental students from the University of Eastern Finland were randomly grouped into even-sized groups. *denotes a significant difference between groups, p < 0.05, one-way ANOVA