Gamified Learning in a Virtual World for Undergraduate Emergency Radiology Education: Quasi-Experimental Study

Abstract

Objective: This study aimed to assess the feasibility of learning emergency radiology in the virtual world Second Life (Linden Lab) through a gamified experience by evaluating team performance in clinical case resolution, individual performance on seminar assessments, and students’ perceptions of the activity. Methods: Teams of 3-4 final-year medical students, during a 2-week radiology clerkship, had access to 7 clinical cases in virtual clinical stations and were randomly assigned 2 to solve and submit. They later discussed the cases in a synchronous virtual meeting and attended an emergency radiology seminar. Results: The perception questionnaire had a 90.6% response rate. The highest cognitive load was observed in avatar editing (median 7, 95% CI 6.56-6.96). Case-solving cognitive load was significantly lower in 2021-2022 compared with 2020-2021 (median 6, 95% CI 5.69-6.21 vs 5.10-5.66; P<.001). The students rated the experience highly, with average scores exceeding 8.0 out of 10 across various aspects. Notably, the highest-rated aspects were the teaching staff (9.13, SD 1.15), cases (8.60, SD 1.31), project organization (8.42, SD 1.67), and virtual rooms (8.36, SD 1.62). The lowest-rated aspect was internet connectivity (6.68, SD 2.53). Despite the positive scores, all aspects were rated significantly lower in 2021-2022 compared with 2020-2021. These year-to-year comparisons in performance and perception support the reproducibility of the experience. Conclusions: This study demonstrates that a game-based learning experience in the Second Life virtual world, combining virtual clinical scenarios and team-based tasks, is feasible and reproducible within a radiology clerkship. Students showed strong performance in case resolution and rated the experience highly, within a playful context that integrated asynchronous and synchronous activities.