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Gamification versus Face-to-Face Learning Approach in Point-of-Care Ultrasound Training: A Randomized Controlled Trial


 Background: Although gamification increases user engagement, its effectiveness in point-of-care ultrasound training may yet to be fully established. This study was conducted with the primary outcome of evaluating its effectiveness in point-of-care ultrasound training workshop as compared to conventional face-to-face learning. Methods: Participants (who were junior doctors between 2 – 4 years of clinical experience) were randomized into either the (1) gamification or the (2) face-to-face learning arms. Similar educational intervention was implemented to participants in both arms but the in-gamification arm, the theory assessment was administered in the form of live quizzes with real time leaderboards, and the practical assessment was administered in the form of 3 games, i.e., ultrasound minefield, ultrasound pong and ultrasound game. Pre-test, post-test and 2 months post-training theory and practical assessments were conducted. Results: A total 32 junior doctors participated in this study (16 participants in each arm). For theory assessment, paired student’s t-test showed significant improvement in both face-to-face learning (pre-test score: 12.38 vs post-test score: 19.88; 95% CI [5.35, 9.65] p < 0.001) and gamification arms (pre-test score: 13.38 vs post-test score: 20.81; 95% CI [5.93, 8.94] p < 0.001). For the practical assessment, paired student’s t-test showed significant improvement in gamification arm (pre-test score: 12.56 vs post-test score: 18.13; 95% CI [2.44, 8.69] p<0.001) but not the in the face-to-face learning arm (pre-test score: 16.00 vs post-test score: 18.38; 95% CI [-0.17, 4.92] p<0.065). When re-tested 2 months post-training, both face-to-face learning and gamification arms showed significant improvement for both theory and practical assessment. Conclusions: Gamification approach could be an effective alternative or more effective than face-to-face learning in point-of-care ultrasound training.