Quality of Evidence and Pedagogical Strategy in Using Gamification in Medical Education Literature: A Systematic Review

Gamification is the use of game principles in non-game settings such as medical education. Effective evidence for using gamification in medical education needs well-designed studies that describe outcomes related to interventions. The study objective was to systematically review the study designs describing gamification interventions in medical education focusing on their characteristics and medical students’ learning. We systematically searched the databases, including Google Scholar, PubMed, Scopus, and Web of Science until 2021. Articles were appraised using the Medical Education Research Quality Instrument (MERSQI). The search result included 423 articles, of which 53 articles had inclusion criteria. Of these, 23 articles were classified in the non-electronic games group and 30 studies in the electronic games group. The quality of evidence in both groups was assessed using the MERSQI average checklist. In total, 90% of studies reported the effectiveness of game intervention in one of the 4 levels of the Kirkpatrick pyramid. The predominant pedagogical approach in both groups was the cognitive approach. The psychomotor approach and the affective approach were more prominent in the electronic and non-electronic games groups, respectively. This study shows that gamification training techniques improve the performance of medical students in most cases.