Gamification for the Win in Internal Medicine Residency: A Longitudinal, Innovative, Team-Based, Gamified Approach to Internal Medicine Board-Review

Background: Game-based learning is an engaging and effective educational strategy in medical education. The Internal Medicine resident board review at our institution was considered dull and poorly attended by trainees. We hypothesized that a gamified, longitudinal, team-based approach to board review would rejuvenate board review and improve learner perception of quality and attendance. Methods: We sought to improve the resident perception of and participation in board review through an innovative longitudinal, team-based, game-based intervention, the "Cohort Cup". The "Cohort Cup" was developed and implemented over a 22-week intervention period from November 2017 to May 2018. Teams (cohorts) competed in real-time against one another. Evaluation methods include a pre/post attitudes survey on a 5-point Likert scale (1 - strongly disagree, 5 - strongly agree) and attendance data. Findings: Of 105 residents eligible to participate, 82 completed the pre-intervention survey, and 74 completed the post-intervention survey. We observed statistically significant increases in self-perceptions of engagement, the perceived value of the sessions, and preferences for game-based learning. Self-perceptions of learner engagement improved from 2.74 to 3.8. The value of the educational experience increased from 2.68 to 3.95. Preferences for game-based learning improved from 3.77 to 4.32. Board review attendance doubled. Residents commented the intervention improved class bonding. Board passage rate increased from 86% to 97%. Conclusions: Our game-based intervention successfully rejuvenated our board review. We observed more joy in the learning environment and improvements in resident engagement, and in their attitudes regarding board review. Game-based learning can be a valuable educational tool and can be a positive facet of educational communities.