The study of learning outcome of atherosclerotic cardiovascular disease (ASCVD) prevention by card game added on interactive lecture and group activity

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Abstract

Background: Atherosclerotic cardiovascular disease (ASCVD) prevention represents a fundamental competency for general practitioners. However, students found that the ASCVD prevention course was content-heavy and disengaging. To address this, the ASCVD Prevention Card Game was created as a game-based learning tool to enhance engagement and knowledge retention. This study evaluated its learning outcomes and student perception when integrated alongside lectures and group activities. Methodology: This quasi-experimental study compared the learning outcomes of the game, integrated into the 2024 course, with the 2023 course prior to its integration among fourth-year medical students at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand. This is a multiplayer, turn-based game designed for 2-6 players. In 2023, the course comprised 18 hours of instruction, including interactive lectures, readiness assurance tests (RAT), outpatient teaching, and case-based learning. In 2024, the course was condensed to 16 hours with the integration of the game, while maintaining core content. Baseline student knowledge was assessed using the individual RAT (iRAT) and pre-test. Learning outcomes were evaluated through pre- and post-test comparisons and cross-year analysis of summative assessments, with routine and randomized blinded re-evaluation to minimize bias. Student perception was assessed using a five-point Likert scale questionnaire. Results: The mean iRAT score for the 2024 cohort was significantly lower than that of the 2023 cohort. Nevertheless, within the 2024 cohort, the mean post-test score improved significantly following participation in the card game. No statistically significant differences were observed in summative examination scores between the two cohorts, as confirmed by both routine assessment and random re-evaluation. The majority of students strongly agreed that the game was engaging, enjoyable, well-designed, and effective in facilitating learning. Conclusion: The game appeared to enhance student engagement, enjoyment and promote learning. Significant improvements in post-test scores support its potential as an effective interactive educational tool. Although summative scores were comparable to those of the previous year, the game helped sustain learning outcomes despite reduced instructional time and lower baseline knowledge. These findings support the integration of game-based learning in health professions education. Further research is warranted to evaluate its long-term effectiveness and applicability in clinical practice. Clinical trial number: Not applicable

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