The lipid leaderboards: A virtual gamified curriculum to educate internal medicine residents on guideline-based management of hyperlipidemia

Background/Synopsis

Dyslipidemia remains a prevalent risk factor for cardiac disease, and effective education of trainees on best practice guidelines is essential. There is an increasing interest in gamification as a tool for medical education, due to its benefits on learner engagement and knowledge.

Objective/Purpose

We investigated the effectiveness of gamification in educating internal medicine residents on hyperlipidemia at a single, large academic internal medicine program. We compared a gamified interactive curriculum to a traditional slide-based curriculum on objective measures of test performance as well as self-reported ratings of confidence, knowledge, and motivation.

Methods

Residents received a 45-minute resident-led, case-based session summarizing 2018 ACC/AHA Guidelines, the 2022 AHA Expert Consensus Decision Pathway, and 2022 USPSTF Guidelines on management of hyperlipidemia delivered in a gamified format utilizing KAHOOT!® or a traditional slide-based format. Residents were invited to complete pre- and post-surveys which included knowledge questions, 5-point Likert scales (1 to 5) assessing knowledge, engagement, and motivation, and one question regarding preference of format. Matched pre-post data was analyzed with paired students’ t-tests with unequal variance.

Results

37 of 108 total residents (34.2%) completed pre-post surveys: 24/65 (36.9%) in the gamified and 13/43 (40.2%) in the traditional group. The gamified (mean pre- 56% to post- 74%, p = < 0.01) and traditional (mean pre- 44% to post- 63%, p = 0.01) groups had significant increases in knowledge test scores after the session. Between both groups, there was no difference in the increase in test scores (gamified post-pre 17.8% vs. traditional 18.3%, p = 0.46) or increase in Likert scale ratings of knowledge (gamified post-pre 0.95 vs. traditional 0.91, p = 0.43). There was also no difference in post-session Likert scale ratings of engagement (gamified 4.3 vs. traditional 4.4, p = 0.42) or motivation in adhering to guidelines (gamified 4.3 vs. 4.5, p = 0.14). 42% of residents in the traditional group and 92% in the gamified group desired a gamified format for future sessions.

Conclusions

Both gamified and traditional formats significantly improved knowledge of hyperlipidemia guidelines. A gamified format was non-inferior to traditional format in post-session Likert scale ratings of engagement and motivation. A greater majority of residents desired a gamified format for future sessions. Gamification is an effective teaching method with similar outcomes to traditional methods. Effective education on professional guidelines pertaining to hyperlipidemia may lead to more evidence driven management of dyslipidemia and improve clinical outcomes.