In most medical schools around the world, the teaching of pharmacology is lecture- based where students are passive listeners receiving a massive amount of knowledge about drugs and prescribing them medicines, and they are expected to memorize, retain, and interpret the knowledge effectively within a relatively short period of time (Seth et al., 2010; Chavda et al., 2011; Gillani et al., (2018). This didactic approach has been widely used for a long time. Unsurprisingly, therefore, it is an accepted notion among medical students that pharmacology classes are the most tedious and least useful to them (Naeem et al., 2012; Mustafa et al., 2016).
Integrating practical pharmacology sessions into the curriculum has been an ongoing challenge for course designers. There is a need to explore effective ways of teaching this challenging subject by creating a teaching environment conducive to learning and much-needed creative thinking, analytic, and argumentation skills achievable through interactive teaching methods, as demonstrated by Giorgdze and Dgebuadze (2017). Interactive learning has been found to encourage student teamwork, enhance compassion and listening skills, and improve rational decision-making in new situations, all skills extremely important for medical students in their preparation for becoming competent and caring healthcare practitioners.
Research suggests that Game-based Electronic learning (GbEl) can greatly improve learners’ motivation and participation by presenting the content in an interactive, rule-based and competitive manner which supports the learning process in the cognitive, affective and psychomotor domains (Mitchell and Savill-Smith, 2004; Boeker et al., 2013). In the area of teaching medical content, several studies have demonstrated that electronic games could be an effective tool (Kerfoot et al., 2012; Boeker et al., 2013; Rondon et al., 2013).
This study aims to determine the effect of the interactive electronic gaming software Kahoot!® on the second-year medical students’ perception and academic performance at the King Abdul Aziz University (KAU) in Jeddah, Kingdom of Saudi Arabia (KSA) in their general pharmacology practical sessions.
The use of educational games as study aids and their incorporation into curricula have shown improved students’ attitudes towards learning and enhanced learning outcomes.
There are a variety of modern electronic games that have been successfully used as educational tools in both schools and at the university level. A systematic review by Shawaqfeh (2015) concluded that gamification in healthcare education can improve and evaluate the integration of knowledge, comprehension, and confidence of students. Although some students did not believe that the games improved their overall grades, the majority of them felt that they were more engaged, prepared, and confident to face real-life scenarios due to participating in the different educational games.
Kahoot! is a popular educational game that is being used to develop learners’ skills. It is an online game that can tests students’ knowledge, is free, and simply requires a multimedia tool participation like a cell phone, laptop, or Chromebook for running the Kahoot! website (Siegle, 2015). Faculty members can create quizzes in a game-based format using multiple-choice questions. The questions can contain various multimedia contents, such as pictures or videos (Siegle, 2015) and can be based on real-life scenarios, thereby approximating practice-oriented learning. There are several studies on the use of Kahoot! as an educational tool both at the school and university levels.
A cross-sectional study conducted by Ismail and Mohammad (2017) involving 113 first-year medical students in Malaysia to explore the advantages of gamification through Kahoot! platform for formative assessment in medical education found that Kahoot! sessions motivated students to study, focus on the important concepts and reflect on what they had learned. They concluded that it was a promising formative assessment tool in medical education and recommended health professions educators include it into their teaching and learning activities, particularly for formative assessment.
A study conducted by Curto et al. (2019) on a sample of 68 secondary school students (aged 12 to 16 years old) evaluating the use of Kahoot! in mathematics, biology and geology and physics and chemistry reported that students became more confident and engaged in meaningful learning activities when the classroom environment became more interactive with Kahoot!. The online questionnaires created by the teachers with Kahoot! for which the students could get immediate feedback for each answer allowed the teachers to be informed of the degree of learning achieved by students and the statistics of the data almost immediately. Overall, the results on the benefits on the learning process were very positive and helped to examine the potential of further use of online questionnaires in the classrooms.
Felszeghy et al. (2019) examined the effect of using Kahoot! in histology teaching at medical and dental school classes at the University of Eastern Finland. The participation in Kahoot! by 160 students was successful and resulted in learning gains. 77.5% (124/160) of students indicated that gamification increased their motivation to learn. The gaming approach also helped students overcome individual difficulties (139/160) and set up collaboration (107/160). Also, gamification promoted interest (109/160) and the respondents found the immediate feedback on their answers in the game to be a positive feature (146/160).
In KSA, gaming has also been used successfully as an educational tool; wherein many studies have shown its effectiveness in improving student learning (Al-Zahrani, 2015; Alqurashi et al., 2016). However, most of the studies have been done in schools. Alqurashi et al. (2016) identified three factors that significantly influenced middle school students in KSA towards gaming: competition, discovery, and knowledge. Sulphey (2017) and Albarakati (2019) evaluated the possibility of utilizing GbEl in dealing with the issues of student engagement and motivation in the higher education sector in KSA, with Sulphey (2017) concluding that GbEl would be an excellent aid to engage students more effectively and help to transform the higher education sector and that it would bypass the traditional “teacher-centred approach” in teaching.
To the author’s best knowledge, no previous research has been conducted evaluating the effectiveness of Kahoot! in the medical education sector in KSA, which makes this cross-sectional study the first study of its type.