JMIR Publications

ABSTRACT

Background:

Gamification has proven useful in enhancing knowledge outcomes and learner engagement in healthcare professions education. In dentistry, early and effective infection control education is crucial, due to significant occupational and safety risks in the dental practice from disease transmission through bodily fluids and sharps handling. Despite the importance of optimising the understanding and retention of infection control principles, the application of gamified learning to dental infection control is lacking. Furthermore, no prior study has evaluated a purpose-built gamified infection control module for dental students using a randomised controlled design.

Objective:

This study aimed to evaluate the effectiveness of a gamified infection control module compared to traditional lectures, in terms of knowledge gains and learner perceptions of usability, engagement, and educational value.

Methods:

A purpose-built web-based game was developed, incorporating 50 multiple-choice questions over three levels in a 2-dimensional side-scrolling platformer interface. Usability testing was performed prior to study implementation. A two-arm, parallel-group randomised controlled trial was conducted, recruiting first-year undergraduate dental students. Participants were randomised to participate in the game (game group) or the traditional infection control lecture (lecture group), both conducted in person with a facilitator present. All participants completed a 25-item assessment pre- and post intervention. To evaluate game perception, game group participants were also asked to complete a survey with 15 Likert-scale items over four sections (Usability, Engagement and Motivation, Educational Value and Overall Feedback) and one open-ended item. Likert-scale items were analysed numerically, with more positive sentiments having higher values (from 1-5).

Results:

The study included 74 participants, with 37 in the game group and 37 in the lecture group. While both groups demonstrated statistically significant pre-to-post improvements in assessment scores (both P<.001), the game group showed a larger effect size (Cohen d=1.69 vs. 0.89), and significantly greater post-test scores (P=0.01, Cohen d=0.60) and score improvements (t-test P=.002, Mann-Whitney P=.003). Survey results showed majority positive responses across all sections, with Educational Value having the highest domain scores (3.97 ± 1.14, 77.8% agree/strongly agree), and Usability having the lowest scores and highest response variability (3.71 (SD 1.32), 67.7% agree/strongly agree). Thematic analysis of open-ended responses found generally positive reception, with feedback requesting reduced game length and complexity as well as immediate corrective feedback.

Conclusions:

Browser-based gamified infection control learning produced significantly greater knowledge gains compared to a traditional lecture. Game group participants rated the game positively for engagement and educational value, and most preferred it over lectures. These findings support gamification as an effective and engaging pedagogical approach in dental infection control education and provide a strong foundation for a larger multicentre trial and iterative game refinement.