Background Serious games have the potential to resolve educational problems faced by medical students, such as insufficient rehearsal due to boredom and lack of motivation. However, serious games’ relatively novel concepts in science and many genres of games that are common in recreation remain underresearched in the literature. Board games are one such genre that, despite their potential, affordability, and flexibility, are rarely designed for medical students, and little is known about student perceptions of them and their compatibility with rehearsal. Objective In this cross-sectional study, we sought to elicit, via an exploratory mixed methods approach, student perceptions of a digital serious board game specifically designed for the gamified rehearsal of complex medical subjects, with the chosen topic of anatomy. Methods A digital serious board game, based on self-determination theory (SDT), was first designed and developed to facilitate the rehearsal of anatomy information. Students were then voluntarily recruited to partake in the intervention and were randomly split into three teams of 2 players per game session, after which they were administered the Flow Short Scale (FSS), which is a 13-item measure where items were rated on a 7-point Likert scale ranging from 1 (“not at all”) to 7 (“very much”). Students then participated in a focus group discussion to elicit their perceptions of the game. Findings from the FSS were subject to descriptive analysis, and the focus group discussion was subject to inductive thematic analysis. Results A total of 12 undergraduate, second-year medical students from the Lee Kong Chian School of Medicine in Singapore participated in the study. FSS results indicated a moderate level of overall flow (mean score 4.94, SD 1.07) via the subdomains of fluency (mean score 4.77, SD 1.13) and absorption (mean score 5.21, SD 1.1). Students perceived the game as fun, enjoyable, engaging, and appropriate as a rehearsal tool that alleviated the monotony of traditional methods of rehearsal. Conclusions Our digital board game–based rehearsal tool, when based on SDT, appeared to be suitable for gamified rehearsal in a fun and enjoyable environment due to its facilitation of intrinsic motivation in its players.

Serious games may resolve problems relating to low motivation in complex medical topics such as anatomy. However, they remain relatively novel introductions to the science of learning, and further research is required to ascertain their benefits. This study describes the overall development and testing of a digital serious boardgame designed to facilitate the rehearsal of musculoskeletal anatomy based on self‐determination theory with considerations for the psychological state of Flow. It was hypothesized that students assigned to the intervention game condition would attain higher Flow scores, a measure of engagement and intrinsic motivation, than students assigned to the game‐free control, and that the intervention condition would report either superior or non‐superior, but not inferior, scores on a surprise recall test. A total of 36 second‐year undergraduate medical students participated in the quasi‐randomized controlled trial, where the intervention groups went first and randomly drew questions that were mirrored into the control groups. All students were administered an identical 10‐question baseline assessment before their interventions, the Short Flow Scale immediately after, and a surprise test four‐to‐six weeks later. Independent samples t‐tests indicated that students of both conditions were of similar baseline knowledge (t = 0.7, p = 0.47), significantly higher Flow scores in the game condition (t = 2.99, p = 0.01), and no significant differences between surprise test scores (t = −0.3, p = 0.75). The game appears to be an appropriate game‐based tool for student rehearsal of anatomical education, stemming from a strong theoretical base that facilitates high engagement and intrinsic motivation.

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