Effect of a multimodal playful-educational intervention on academic performance in human anatomy content among General Unified Baccalaureate students in Imbabura, Ecuador, 2026

Authors

DOI:

https://doi.org/10.70577/yghkv767

Keywords:

Human anatomy; game-based learning; upper-secondary education; gamification; quasi-experimental study.

Abstract

The objective was to evaluate changes in academic performance following a multimodal game-based educational intervention for teaching human anatomy to upper-secondary students. A quantitative, quasi-experimental, one-group pretest-posttest study was conducted with 706 students from an educational institution in Imbabura, Ecuador. The intervention addressed body cavities and regions, the cardiovascular system, and the respiratory system through educational challenges, interactive games, model construction, and anatomical practice. Pretest-posttest differences were examined using the exact sign test, 95% confidence intervals, directional effect sizes, and Holm adjustment. All nine comparisons by grade and content were statistically significant (adjusted p < 0.001), with δ values ranging from 0.982 to 1.000. The proportion of scores equal to or above seven increased from 10.25% to 93.67%. The intervention was associated with systematic improvement and high student satisfaction. Satisfaction response rates varied across grades and required further cautious interpretation; however, the lack of a control group limited causal inference.

Downloads

Download data is not yet available.

References

Ainsworth, S., Prain, V., & Tytler, R. (2011). Drawing to learn in science. Science, 333(6046), 1096–1097. https://doi.org/10.1126/science.1204153 DOI: https://doi.org/10.1126/science.1204153

Ang, E. T., Chan, J. M., Gopal, V., & Li Shia, N. (2018). Gamifying anatomy education. Clinical Anatomy, 31(7), 997–1005. https://doi.org/10.1002/ca.23249 DOI: https://doi.org/10.1002/ca.23249

Arruzza, E., & Chau, M. (2021). A scoping review of randomised controlled trials to assess the value of gamification in the higher education of health science students. Journal of Medical Imaging and Radiation Sciences, 52(1), 137-146. https://doi.org/10.1016/j.jmir.2020.10.003 DOI: https://doi.org/10.1016/j.jmir.2020.10.003

Bai, S., Hew, K. F., & Huang, B. (2020). Does gamification improve student learning outcome? Evidence from a meta-analysis and synthesis of qualitative data in educational contexts. Educational Research Review, 30, 100322. https://doi.org/10.1016/j.edurev.2020.100322 DOI: https://doi.org/10.1016/j.edurev.2020.100322

Bogomolova, K., van der Ham, I. J. M., Dankbaar, M. E. W., van den Broek, W. W., Hovius, S. E. R., van der Hage, J. A., & Hierck, B. P. (2020). The effect of stereoscopic augmented reality visualization on learning anatomy and the modifying effect of visual-spatial abilities: A double-center randomized controlled trial. Anatomical Sciences Education, 13(5), 558-567. https://doi.org/10.1002/ase.1941 DOI: https://doi.org/10.1002/ase.1941

Chytas, D., Piagkou, M., & Natsis, K. (2022). Outcomes of the implementation of game-based anatomy teaching approaches: An overview. Morphologie, 106(352), 8–14. https://doi.org/10.1016/j.morpho.2021.02.001 DOI: https://doi.org/10.1016/j.morpho.2021.02.001

Clark, D. B., Tanner-Smith, E. E., & Killingsworth, S. S. (2016). Digital games, design, and learning: A systematic review and meta-analysis. Review of Educational Research, 86(1), 79–122. https://doi.org/10.3102/0034654315582065 DOI: https://doi.org/10.3102/0034654315582065

Donkin, R., & Rasmussen, R. (2021). Student perception and the effectiveness of Kahoot!: A scoping review in histology, anatomy, and medical education. Anatomical Sciences Education, 14(5), 572–585. https://doi.org/10.1002/ase.2094 DOI: https://doi.org/10.1002/ase.2094

Estai, M., & Bunt, S. (2016). Best teaching practices in anatomy education: A critical review. Annals of Anatomy, 208, 151–157. https://doi.org/10.1016/j.aanat.2016.02.010 DOI: https://doi.org/10.1016/j.aanat.2016.02.010

Felszeghy, S., Pasonen-Seppänen, S., Koskela, A., Nieminen, P., Härkönen, K., Paldanius, K. M. A., Gabbouj, S., Ketola, K., Hiltunen, M., Lundin, M., Haapaniemi, T., Sointu, E., Bauman, E. B., Gilbert, G. E., Morton, D., & Mahonen, A. (2019). Using online game-based platforms to improve student performance and engagement in histology teaching. BMC Medical Education, 19, 273. https://doi.org/10.1186/s12909-019-1701-0 DOI: https://doi.org/10.1186/s12909-019-1701-0

Fiorella, L., & Mayer, R. E. (2016). Eight ways to promote generative learning. Educational Psychology Review, 28(4), 717–741. https://doi.org/10.1007/s10648-015-9348-9 DOI: https://doi.org/10.1007/s10648-015-9348-9

Freeman, S., Eddy, S. L., McDonough, M., Smith, M. K., Okoroafor, N., Jordt, H., & Wenderoth, M. P. (2014). Active learning increases student performance in science, engineering, and mathematics. Proceedings of the National Academy of Sciences, 111(23), 8410–8415. https://doi.org/10.1073/pnas.1319030111 DOI: https://doi.org/10.1073/pnas.1319030111

Gentry, S. V., Gauthier, A., L’Estrade Ehrstrom, B., Wortley, D., Lilienthal, A., Tudor Car, L., Dauwels-Okutsu, S., Nikolaou, C. K., Zary, N., Campbell, J., & Car, J. (2019). Serious gaming and gamification education in health professions: Systematic review. Journal of Medical Internet Research, 21(3), e12994. https://doi.org/10.2196/12994 DOI: https://doi.org/10.2196/12994

Giler-Medina, P., Giler-Medina, C., & Medina-Gorozabel, G. (2024). Uso del Atlas 3D en el aprendizaje de la Anatomía Humana en estudiantes de Bachillerato. Sociedad & Tecnología, 7(2), 146–162. https://doi.org/10.51247/st.v7i2.421 DOI: https://doi.org/10.51247/st.v7i2.421

Karpicke, J. D., & Blunt, J. R. (2011). Retrieval practice produces more learning than elaborative studying with concept mapping. Science, 331(6018), 772–775. https://doi.org/10.1126/science.1199327 DOI: https://doi.org/10.1126/science.1199327

Khalil, M. K., Abdel Meguid, E. M., & Elkhider, I. A. (2018). Teaching of anatomical sciences: A blended learning approach. Clinical Anatomy, 31(3), 323–329. https://doi.org/10.1002/ca.23052 DOI: https://doi.org/10.1002/ca.23052

Latre-Navarro, L., Quintas-Hijos, A., & Sáez-Bondía, M. J. (2024). The combined effects of an anatomy program integrating drawing and gamification on basic psychological needs satisfaction among sport sciences students: Results of a natural experiment. Anatomical Sciences Education, 17(2), 366-378. https://doi.org/10.1002/ase.2358 DOI: https://doi.org/10.1002/ase.2358

Lim, K. H. A., Loo, Z. Y., Goldie, S. J., Adams, J. W., & McMenamin, P. G. (2016). Use of 3D printed models in medical education: A randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anatomical Sciences Education, 9(3), 213-221. https://doi.org/10.1002/ase.1573 DOI: https://doi.org/10.1002/ase.1573

López-Jiménez, J. J., Fernández-Alemán, J. L., García-Berná, J. A., López-González, L., González-Sequeros, O., Nicolás-Ros, J., Carrillo-de-Gea, J. M., Idri, A., & Toval, A. (2021). Effects of gamification on the benefits of student response systems in learning of human anatomy: Three experimental studies. International Journal of Environmental Research and Public Health, 18(24), 13210. https://doi.org/10.3390/ijerph182413210 DOI: https://doi.org/10.3390/ijerph182413210

Lorenzo-Álvarez, R., Rudolphi-Solero, T., Ruiz-Gómez, M. J., & Sendra-Portero, F. (2020). Game-based learning in virtual worlds: A multiuser online game for medical undergraduate radiology education within Second Life. Anatomical Sciences Education, 13(5), 602-617. https://doi.org/10.1002/ase.1927 DOI: https://doi.org/10.1002/ase.1927

Moro, C., Birt, J., Stromberga, Z., Phelps, C., Clark, J., Glasziou, P., & Scott, A. M. (2021). Virtual and augmented reality enhancements to medical and science student physiology and anatomy test performance: A systematic review and meta-analysis. Anatomical Sciences Education, 14(3), 368-376. https://doi.org/10.1002/ase.2049 DOI: https://doi.org/10.1002/ase.2049

Peterson, D. C., & Mlynarczyk, G. S. A. (2016). Analysis of traditional versus three-dimensional augmented curriculum on anatomical learning outcome measures. Anatomical Sciences Education, 9(6), 529-536. https://doi.org/10.1002/ase.1612 DOI: https://doi.org/10.1002/ase.1612

Roediger, H. L., & Karpicke, J. D. (2006). Test-enhanced learning: Taking memory tests improves long-term retention. Psychological Science, 17(3), 249–255. https://doi.org/10.1111/j.1467-9280.2006.01693.x DOI: https://doi.org/10.1111/j.1467-9280.2006.01693.x

Rudolphi-Solero, T., Lorenzo-Álvarez, R., Ruiz-Gómez, M. J., & Sendra-Portero, F. (2022). Impact of compulsory participation of medical students in a multiuser online game to learn radiological anatomy and radiological signs within the virtual world Second Life. Anatomical Sciences Education, 15(5), 863-876. https://doi.org/10.1002/ase.2134 DOI: https://doi.org/10.1002/ase.2134

Sailer, M., & Homner, L. (2020). The gamification of learning: A meta-analysis. Educational Psychology Review, 32(1), 77–112. https://doi.org/10.1007/s10648-019-09498-w DOI: https://doi.org/10.1007/s10648-019-09498-w

Stambuk Castellano, M., Contreras-McKay, I., Neyem, A., Farfán, E., Inzunza, O., Ottone, N. E., Del Sol, M., Alario-Hoyos, C., Soto Alvarado, M., & Tubbs, R. S. (2024). Empowering human anatomy education through gamification and artificial intelligence: An innovative approach to knowledge appropriation. Clinical Anatomy, 37(1), 12–24. https://doi.org/10.1002/ca.24074 DOI: https://doi.org/10.1002/ca.24074

Subhash, S., & Cudney, E. A. (2018). Gamified learning in higher education: A systematic review of the literature. Computers in Human Behavior, 87, 192-206. https://doi.org/10.1016/j.chb.2018.05.028 DOI: https://doi.org/10.1016/j.chb.2018.05.028

Sugand, K., Abrahams, P., & Khurana, A. (2010). The anatomy of anatomy: A review for its modernization. Anatomical Sciences Education, 3(2), 83–93. https://doi.org/10.1002/ase.139 DOI: https://doi.org/10.1002/ase.139

Tarca, A., Woo, N., Bain, S., Crouchley, D., McNulty, E., & Yim, D. (2023). 3D printed cardiac models as an adjunct to traditional teaching of anatomy in congenital heart disease: A randomised controlled study. Heart, Lung and Circulation, 32(12), 1443-1450. https://doi.org/10.1016/j.hlc.2023.09.021 DOI: https://doi.org/10.1016/j.hlc.2023.09.021

Triepels, C. P. R., Smeets, C. F. A., Notten, K. J. B., Kruitwagen, R. F. P. M., Fütterer, J. J., Vergeldt, T. F. M., & van Kuijk, S. M. J. (2020). Does three-dimensional anatomy improve student understanding? Clinical Anatomy, 33(1), 25-33. https://doi.org/10.1002/ca.23405 DOI: https://doi.org/10.1002/ca.23405

Van Gaalen, A. E. J., Brouwer, J., Schönrock-Adema, J., Bouwkamp-Timmer, T., Jaarsma, A. D. C., & Georgiadis, J. R. (2021). Gamification of health professions education: A systematic review. Advances in Health Sciences Education, 26(2), 683–711. https://doi.org/10.1007/s10459-020-10000-3 DOI: https://doi.org/10.1007/s10459-020-10000-3

Van Nuland, S. E., Roach, V. A., Wilson, T. D., & Belliveau, D. J. (2015). Head to head: The role of academic competition in undergraduate anatomical education. Anatomical Sciences Education, 8(5), 404-412. https://doi.org/10.1002/ase.1498 DOI: https://doi.org/10.1002/ase.1498

Winkelmann, A. (2007). Anatomical dissection as a teaching method in medical school: A review of the evidence. Medical Education, 41(1), 15–22. https://doi.org/10.1111/j.1365-2929.2006.02625.x DOI: https://doi.org/10.1111/j.1365-2929.2006.02625.x

Yammine, K., & Violato, C. (2015). A meta-analysis of the educational effectiveness of three-dimensional visualization technologies in teaching anatomy. Anatomical Sciences Education, 8(6), 525–538. https://doi.org/10.1002/ase.1510 DOI: https://doi.org/10.1002/ase.1510

Yammine, K., & Violato, C. (2016). The effectiveness of physical models in teaching anatomy: A meta-analysis of comparative studies. Advances in Health Sciences Education, 21(4), 883–895. https://doi.org/10.1007/s10459-015-9644-7 DOI: https://doi.org/10.1007/s10459-015-9644-7

Ye, Z., Dun, A., Jiang, H., Nie, C., Zhao, S., Wang, T., & Zhai, J. (2020). The role of 3D printed models in the teaching of human anatomy: A systematic review and meta-analysis. BMC Medical Education, 20, 335. https://doi.org/10.1186/s12909-020-02242-x DOI: https://doi.org/10.1186/s12909-020-02242-x

Downloads

Published

2026-08-28

How to Cite

Effect of a multimodal playful-educational intervention on academic performance in human anatomy content among General Unified Baccalaureate students in Imbabura, Ecuador, 2026. (2026). Salud Medicina E Innovación Journal, 4(3), 562-582. https://doi.org/10.70577/yghkv767

Similar Articles

1-10 of 100

You may also start an advanced similarity search for this article.