Research Questions

  • How does the presence of game design influence the frequency of study aid use and breadth of use?
  • How do personal characteristics, such as gender, studying habits, and gaming habits influence voluntary use and learning in the study aids?
  • How is study aid performance predictive of learning outcomes? How is this different between groups?



  • We compared voluntary use of a game- and a non-game-study aid by medical students.
  • We investigated how anatomy learning related to use and demographic traits.
  • The gaming group used their study aid to a greater extent than the control group, though results were only trending.
  • Studying with the game encouraged more strategic thinking from users, leading to greater predictability of learning outcomes.
  • Reported studying habits had opposite effects on use between study aid treatments.
  • Game design in educational tools may increase use and assessment capabilities.

Investigating how game design influences students’ interactions, leading to more predictable learning outcomes.


About this research project

This project investigates the influence of game design on study-aid use patterns and learning among undergraduate students. To do this, we developed two study-aids for students learning human vascular anatomy… the only difference between them is that the experimental tool, Vascular Invaders (VI), incorporates game design (e.g. rules and goals, points, leaderboard, achievements, etc.), whereas the control tool, the Vascular Anatomy Study Aid (VASA), does not.

Both study aids were created around the same evidence-centred design framework:

  • Student Model: vasculature of the head and neck
  • Task Model: vascular-sequencing tasks
  • Evidence Model: tool-use and performance metrics.

We hypothesized that the presence of game design would encourage greater engagement with the Task Model, resulting in higher measured study aid performance. In turn, higher study aid performance metrics would be predictive of greater learning of the Student Model in both treatments.

We were interested in the educational affordances of the additional game design in Vascular Invaders, particular to the evidence-centred design framework. Medical students at the University of Toronto were randomly divided into two groups; Vascular Invaders (n=24) and the control application (n=22). We digitally collected tool-use data (e.g. tasks completed, tasks attempted, breadth of material covered, usage sessions, interaction with various elements) over 35 days and tested their knowledge with pre-post anatomy tests.

Ultimately, the findings of this study suggest that adding game design to a vascular anatomy study aid may motivate increased voluntary use by medical students, though only trending differences were observed (p=0.11). Perhaps the most pertinent finding was an unexpected one: study aid performance was a significant predictor of learning in the game group (β=0.41, p=0.05) but not in the control group (β=0.14, p=0.56). Our analyses suggest that game mechanics encouraged more specific problem-solving strategies than did the control study aid, leading to greater predictability of learning outcomes. Future educational games should be created with this in mind; game mechanics should enhance evidence-centred design by eliciting actions from the player that require him/her to reflect on the target concepts so that patterns of interactions can be related directly to the players’ knowledge. This represents a unique contribution of game design to a digital application.

Scatterplot with regression line showing Actual test improvement scores over regression predicted test improvement values for students who played Vascular Invaders and those that used the Vascular Anatomy Study Aid

Images of control application: Vascular Anatomy Study Aid

Play Vascular Invaders!

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Try the Vascular Anatomy Study Aid!

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