{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:50:47Z","timestamp":1792086647985,"version":"4.4.0"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gamification in medical education has typically meant adding badges, points, or leaderboards to existing content. This paper reports medical students\u2019 perceptions of five items evaluating a self-directed radiology department visit built around a themed storybook, a sticker system, a limited-access ID\/passport, and a narrative \u201cKingdom\u201d theme, alongside an overall rating of gamified understanding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-centre, cross-sectional observational survey, third-year medical students enrolled in RAD366 at King Saud University who had completed the Radiology Kingdom activity during the 2025\u20132026 academic year were invited to anonymously report their perceptions of its gamified design elements. Of approximately 270 eligible students, 112 submissions were received (submission rate approximately 41.5%); after exclusion of one probable duplicate, 111 responses were analysed (analytic response rate approximately 41.1%). Four items assessed specific design features and one assessed a global outcome (students\u2019 perceived understanding); differences across items were tested using a Friedman test with Bonferroni-corrected post-hoc comparisons, and between-group comparisons used Mann-Whitney U and Kruskal-Wallis tests. Internal consistency was assessed using Cronbach\u2019s alpha. The questionnaire was administered under Institutional Review Board approval (No. R26-IRB-510) and included an explicit consent statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cronbach\u2019s \u03b1 across the five items was 0.841, indicating substantial inter-item correlation; because the items assess conceptually distinct constructs, this coefficient was not interpreted as evidence of unidimensionality or instrument validity. A Friedman test identified a significant difference across items (\u03c7\u00b2(4)\u2009=\u200932.353,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001): the ID\/passport received significantly lower ratings than the other four items (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001, Bonferroni corrected), while no significant pairwise differences were detected among the Kingdom theme (4.63), gamified understanding (4.60), storybook (4.58), and sticker system (4.52) ratings. Female students gave significantly higher ratings than male students on the composite score (4.64 vs. 4.33;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.023) and on three of five items, an exploratory finding. No significant difference in ratings was detected across visit months or prior radiology exposure groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this single-centre, observational survey, students reported highly positive perceptions of the storybook, Kingdom theme, sticker system, and gamified elements\u2019 perceived contribution to their understanding, whereas the ID\/passport item received significantly lower ratings; because the five items assessed different constructs, this difference reflects differences in student ratings rather than evidence of the comparative educational effectiveness of individual intervention components. These findings demonstrate the feasibility of implementing a resource-modest, narrative-based, self-directed clinical immersion activity within a busy radiology department, rather than evidence that gamification itself improved engagement, understanding, or learning, since the uncontrolled design does not support causal or comparative-effectiveness conclusions. The intervention offers a practical, replicable model for similar self-directed department visits that warrants evaluation in controlled, multi-institutional studies incorporating objective measures of learning and retention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-026-10460-y","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:04:06Z","timestamp":1790222646000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medical students\u2019 perceptions of gamified design elements in a self-directed radiology department visit"],"prefix":"10.1186","volume":"26","author":[{"given":"Sultan R.","family":"Alharbi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"10460_CR1","doi-asserted-by":"publisher","unstructured":"Deterding S, Dixon D, Khaled R, Nacke L. From game design elements to gamefulness: defining gamification. Proc 15th Int Acad MindTrek Conf. 2011;9\u201315. https:\/\/doi.org\/10.1145\/2181037.2181040.","DOI":"10.1145\/2181037.2181040"},{"issue":"1","key":"10460_CR2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s10648-019-09498-w","volume":"32","author":"M Sailer","year":"2020","unstructured":"Sailer M, Homner L. The gamification of learning: a meta-analysis. Educ Psychol Rev. 2020;32(1):77\u2013112. https:\/\/doi.org\/10.1007\/s10648-019-09498-w.","journal-title":"Educ Psychol Rev"},{"issue":"3","key":"10460_CR3","doi-asserted-by":"publisher","first-page":"e12994","DOI":"10.2196\/12994","volume":"21","author":"SV Gentry","year":"2019","unstructured":"Gentry SV, Gauthier A, Ehrstrom BLE, Wortley D, Lilienthal A, Tudor Car L, et al. Serious gaming and gamification education in health professions: systematic review. J Med Internet Res. 2019;21(3):e12994. https:\/\/doi.org\/10.2196\/12994.","journal-title":"J Med Internet Res"},{"issue":"2","key":"10460_CR4","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1007\/s10459-020-10000-3","volume":"26","author":"AEJ van Gaalen","year":"2021","unstructured":"van Gaalen AEJ, Brouwer J, Sch\u00f6nrock-Adema J, Bouwkamp-Timmer T, Jaarsma ADC, Georgiadis JR. Gamification of health professions education: a systematic review. Adv Health Sci Educ Theory Pract. 2021;26(2):683\u2013711. https:\/\/doi.org\/10.1007\/s10459-020-10000-3.","journal-title":"Adv Health Sci Educ Theory Pract"},{"issue":"10","key":"10460_CR5","doi-asserted-by":"publisher","first-page":"5665","DOI":"10.1016\/j.acra.2025.05.070","volume":"32","author":"L Liu","year":"2025","unstructured":"Liu L, Shokralla A, Venalainen E, Leipsic J, Ahmad W, Nicolaou S. Imaging the future: student reflections on an innovative undergraduate radiology course. 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Enhancing radiographic interpretation: effects of gamification on medical students\u2019 knowledge, skills, and satisfaction\u2014a quasi-experimental study. BMC Med Educ. 2025;25(1):958. https:\/\/doi.org\/10.1186\/s12909-025-07523-x.","journal-title":"BMC Med Educ"},{"key":"10460_CR11","doi-asserted-by":"publisher","first-page":"e68518","DOI":"10.2196\/68518","volume":"11","author":"AV P\u00e9rez-Baena","year":"2025","unstructured":"P\u00e9rez-Baena AV, Rudolphi-Solero T, Lorenzo-\u00c1lvarez R, Ruiz-G\u00f3mez MJ, Sendra-Portero F. Gamified learning in a virtual world for undergraduate emergency radiology education: quasi-experimental study. JMIR Med Educ. 2025;11:e68518. https:\/\/doi.org\/10.2196\/68518.","journal-title":"JMIR Med Educ"},{"issue":"1","key":"10460_CR12","doi-asserted-by":"publisher","first-page":"2302231","DOI":"10.1080\/10872981.2024.2302231","volume":"29","author":"YF Wang","year":"2024","unstructured":"Wang YF, Hsu YF, Fang KT, Kuo LT. Gamification in medical education: identifying and prioritizing key elements through Delphi method. Med Educ Online. 2024;29(1):2302231. https:\/\/doi.org\/10.1080\/10872981.2024.2302231.","journal-title":"Med Educ Online"},{"key":"10460_CR13","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139164603","volume-title":"Multimedia Learning","author":"RE Mayer","year":"2001","unstructured":"Mayer RE. Multimedia Learning. Cambridge: Cambridge University Press; 2001."}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-10460-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-10460-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-10460-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:33:39Z","timestamp":1792085619000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-10460-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["10460"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-10460-y","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"assertion":[{"value":"28 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures involving human participants were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments. Institutional ethics approval for this study was obtained from the Institutional Review Board of King Saud University Medical City, College of Medicine, King Saud University (Approval No. R26-IRB-510; approved 29 June 2026). Informed consent to participate was obtained electronically from all participants before they accessed the anonymous questionnaire. The questionnaire\u2019s introductory page explained the purpose of the study, the voluntary nature of participation, the anonymous collection of responses, and that completion and submission of the questionnaire would be taken as indicating informed consent. No identifying data were retained, and all data were stored securely with access restricted to the study team.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. The manuscript\u2019s single figure depicts only educational materials (storybook, activity passport, and sticker set) and contains no identifiable images or personal or clinical details of any participant.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1654"}}