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Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game’s effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements’ underlying theories will be worked out, and third, the game design elements’ effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games.

In the 2020s, it is clear that children now spend most of their days in front of the screen. During screen time, playing games is one of the most important activities of children. However, technology is developing day by day and innovations are quickly becoming a natural part of life. Therefore, children now need to be creative people who produce innovation, rather than just consuming themselves with the digital content offered to them. For this reason, students need to improve their creative thinking skills. Also, they need guidance for producing with technology. Considering this circumstance, this research, which was aimed at 5th and 6th grade school students designed educational games in a blended learning environment, employed a single group pretest posttest experimental design research. At the beginning and end of the research, the creativity level of students was examined by using the Torrance Test of Creativity. The study tries to seek an answer to the following question: “How does the educational game designing process affect 5th and 6th grade students’ creative thinking development?”. As a result, it was determined that there was a statistically significant difference in the creative thinking skill scores of those who designed their own educational game. This result is tangible evidence that the game is not only a drill and practice activity but it also presents a creative thinking environment for students.

This paper reviews the role of Generative Artificial Intelligence (GenAI) in transforming the landscape of educational game design. The recent rise and development of GenAI have expanded its applications in creating dynamic and interactive game systems. This review explores the potential of GenAI to craft personalized educational game designs that can adaptively support real-time student interactions. We discuss GenAI’s capabilities in educational game design and their significance in educational research and practices. In addition, we highlight current design challenges, suggest future research avenues, and discuss the implications of GenAI integration for educational game design and digital game-based learning.

Recent years have seen an emergence of social emotional computer games for individuals with Autism Spectrum Disorder (ASD). These games are heterogeneous in design with few underpinned by theoretically informed approaches to computer-based interventions. Guided by the serious game framework outlined by Whyte et al. (Journal of Autism and Developmental Disorders 45(12):1–12, 2014 ), this study aimed to identify the key motivating and learning features for serious games targeting emotion recognition skills from the perspectives of 11 youth with ASD and 11 experienced professionals. Results demonstrated that youth emphasised the motivating aspects of game design, while the professionals stressed embedding elements facilitating the generalisation of acquired skills. Both complementary and differing views provide suggestions for the application of serious game principles in a potential serious game.

Information literacy (IL) is important for university students. In this research, we developed a digital role-playing game to enhance students’ learning of IL and investigated the effects of gameplay modes on their learning performance, motivation, self-efficacy and flow experiences. A total of 90 students participated in the study and played the game in collaborative, competitive and solo modes. Their IL knowledge was measured through a post-test after they completed the game and associated exercises. Their motivation, self-efficacy and flow experiences were evaluated through a questionnaire survey. The results indicated statistically significant effects of the gameplay modes on the students’ learning performance, motivation, self-efficacy and flow experiences. The solo mode was inferior to the other two in all four aspects. The collaborative mode significantly outperformed the competitive mode in terms of enhancing learning performance and flow experience, while the competitive mode was significantly better in terms of promoting self-efficacy. These two modes were similarly effective in the dimension of motivation. Based on the results, we suggest that students play games in the collaborative or competitive modes when conditions permit. We also advise teachers to provide students with rich opportunities for discussion, collaboration and interaction and believe that an appropriate competitive atmosphere is important.

Objective. The purpose of this study was to extend our understanding of escape room pedagogical design by investigating the impact of escape room puzzle content on changes in students’ immediate recall knowledge and demonstration of interprofessional skills during a subsequent simulation. Methods. Students from nursing, pharmacy, and physical therapy programs were randomized to complete an escape room themed around acute management of sepsis (intervention group; n=133) or general acute care (control group; n=129) prior to participating in a simulated patient discharge case conference. Students completed a knowledge assessment before the escape room, immediately after the escape room, and immediately after the simulation. Additionally, students completed the Interprofessional Socialization and Valuing Scale (ISVS-21) before and after the experience along with a post-program evaluation. Faculty rated student achievement of interprofessional learning objectives during the simulation using a standardized rubric. Results. Students in the intervention group had higher scores on the knowledge test administered immediately after the escape room. All participants’ ISVS-21 scores increased from before to after the activity. Interprofessional learning objectives, as evaluated by faculty, were met by 248 (94.7%) students. Conclusion. Participating in an interprofessional escape room activity with specific puzzle content improved students’ immediate recall knowledge. In both groups, self-assessed interprofessional socialization improved, and a high percentage of students achieved the interprofessional learning objectives in a subsequent simulation. Escape rooms can be an innovative pedagogical tool that can positively impact immediate recall knowledge and interprofessional collaborative skills of health professions students.

This study aims to examine adaptability for educational games in terms of adaptation elements, components used in creating user profiles, and decision algorithms used for adaptation. For this purpose, articles and full-text papers in Web of Science, Google Scholar, and Eric databases between 2000–2021 were searched using the keywords \"educational games\", \"serious games\", \"game-based learning\", \"adapt*\", \"player modeling\", \"user modeling\". After applying the inclusion and exclusion procedures of studies accessed in the search, 26 studies were included in the study. The studies were analyzed in line with the themes determined for the components used in the adaptation of educational games. According to the results, adaptive educational game design was made for a wide variety of fields such as programming teaching, physics, mathematics, computational thinking, and logic. As for adaptive factors; It was determined that adaptations were made for the game, educational content, interface, and non-player character (NPC) behaviors. It is understood that pre-game adaptation and in-game adaptation methods are used as adaptation types. Finally, it is seen that Bayesian networks, artificial neural networks, fuzzy logic, deep learning, item response theory, and decision tree methods are preferred as decision systems in the adaptation process. The findings of this literature review can facilitate the design process by providing a roadmap for researchers interested in adaptive educational game design.

Researchers have investigated how gameplay and other related activities influence teachers’ attitudes toward and perceptions of games or game-based learning. Taking one step further, this study was conducted to investigate how game design experience influences teachers’ attitudes toward and perceptions of the use of digital games in the classroom and teacher involvement in educational game design. Fifty teachers participated in the study. Both quantitative and qualitative data were collected from pre- and post-surveys. The results revealed that the game design experience had a positive influence on the participants’ attitudes, self-efficacy, and perceptions regarding the use of digital games in the classroom. They realized that digital games could help students develop higher-order thinking skills and 21st century skills beyond making learning fun and engaging. After the game design experience, all participants believed that teachers should be involved in the process of educational game design.

In recent years, many researchers have been engaged in the development of educational computer games; however, previous studies have indicated that, without supportive models that take individual students' learning needs or difficulties into consideration, students might only show temporary interest during the learning process, and their learning performance is often not as good as expected. Learning styles have been recognized as being an important human factor affecting students' learning performance. Previous studies have shown that, by taking learning styles into account, learning systems can be of greater benefit to students owing to the provision of personalized learning content presentation that matches the information perceiving and processing styles of individuals. In this paper, a personalized game-based learning approach is proposed based on the sequential/global dimension of the learning style proposed by Felder and Silverman. To evaluate the effectiveness of the proposed approach, a role-playing game has been implemented based on the approach; moreover, an experiment has been conducted on an elementary school natural science course. From the experimental results, it is found that the personalized educational computer game not only promotes learning motivation, but also improves the learning achievements of the students.

As we enter a world of blended learning in higher education, an increased need for adaptation of teaching strategies to enhance engagement has been recognised to amplify learning outcomes online. Gamification has been identified as a creative tool to engage the current cohort of learners who are also characteristically tech-savvy. To this end, escape room games have gained considerable traction in medical and pharmacy education to promote learning, critical thinking and teamwork. In this pilot study we describe the implementation of a 60-minute, web-based hepatitis-themed escape room game within a Year 3 Pharmacotherapy unit at Monash University. A total of 418 students participated in this activity. Students’ knowledge gain on the topic was assessed through a pre- and post-intervention assessment, whereby a statistically significant improvement was seen in the knowledge score following implementation of the gaming activity (58.66% pre-intervention vs. 72.05% post-intervention, p < 0.05). The innovative learning activity was also well perceived by the students. Virtual escape room game is a viable pedagogical approach to teach and reinforce clinical concepts among pharmacy students. With the evolving landscape of education and learner demographics, investment in technology- enhanced game-based learning is a promising trajectory to support students’ growth in a learner-centered environment. A comparison between virtual escape room game and traditional teaching will further inform effectiveness of the gamification on long term knowledge retention.