title: Gaming used as an informal instructional technique: effects on learner knowledge and satisfaction.
abstract: BACKGROUND
  Jeopardy!, Concentration, quiz bowls, and other gaming formats have been incorporated into health sciences classroom and online education. However, there is limited information about the impact of these strategies on learner engagement and outcomes. To address this gap, we hypothesized that gaming would lead to a significant increase in retained short- and long-term medical knowledge with high learner session satisfaction.
  
  
  METHODS
  Using the Jeopardy! game show model as a primary instructional technique to teach geriatrics, 8 PGY2 General Surgery residents were divided into 2 teams and competed to provide the "question" to each stated "answer" during 5 protected block curriculum units (1-h/U). A surgical faculty facilitator acted as the game host and provided feedback and brief elaboration of quiz answers/questions as necessary. Each quiz session contained two 25-question rounds. Paper-based pretests and posttests contained questions related to all core curriculum unit topics with 5 geriatric gaming questions per test. Residents completed the pretests 3 days before the session and a delayed posttest of geriatric topics on average 9.2 weeks (range, 5-12 weeks) after the instructional session. The cumulative average percent correct was compared between pretests and posttests using the Student t test. The residents completed session evaluation forms using Likert scale ratings after each gaming session and each protected curriculum block to assess educational value.
  
  
  RESULTS
  A total of 25 identical geriatric preunit and delayed postunit questions were administered across the instructional sessions. The combined pretest average score across all 8 residents was 51.5% for geriatric topics compared with 59.5% (p = 0.12) for all other unit topics. Delayed posttest geriatric scores demonstrated a statistically significant increase in retained medical knowledge with an average of 82.6% (p = 0.02). The difference between delayed posttest geriatric scores and posttest scores of all other unit topics was not significant. Residents reported a high level of satisfaction with the gaming sessions: The average session content rating was 4.9 compared with the overall block content rating of 4.6 (scale, 1-5, 5 = Outstanding).
  
  
  CONCLUSIONS
  The quiz type and competitive gaming sessions can be used as a primary instructional technique leading to significant improvements in delayed posttests of medical knowledge and high resident satisfaction of educational value. Knowledge gains seem to be sustained based on the intervals between the interventions and recorded gains.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. trwebb@mcw.edu
authors.forename: Travis P
authors.initials: TP
authors.lastname: Webb
authors.forename: Deborah
authors.initials: D
authors.lastname: Simpson
authors.forename: Steven
authors.initials: S
authors.lastname: Denson
authors.forename: Edmund
authors.initials: E
authors.lastname: Duthie
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D005853:Geriatrics / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D008297:Male; D010549:Personal Satisfaction; D011795:Surveys and Questionnaires; D013664:Teaching Materials; D014481:United States; D018910:Video Games