Gamification involves the application of game design elements to traditionally nongame
contexts. It is increasingly being used as an adjunct to traditional teaching strategies
in medical education to engage the millennial learner and enhance adult learning.
The extant literature has focused on determining whether the implementation of gamification
results in better learning outcomes, leading to a dearth of research examining its
theoretical underpinnings within the medical education context. The authors define
gamification, explore how gamification works within the medical education context
using self-determination theory as an explanatory mechanism for enhanced engagement
and motivation, and discuss common roadblocks and challenges to implementing gamification.Although
previous gamification research has largely focused on determining whether implementation
of gamification in medical education leads to better learning outcomes, the authors
recommend that future research should explore how and under what conditions gamification
is likely to be effective. Selective, purposeful gamification that aligns with learning
goals has the potential to increase learner motivation and engagement and, ultimately,
learning. In line with self-determination theory, game design elements can be used
to enhance learners' feelings of relatedness, autonomy, and competence to foster learners'
intrinsic motivation. Poorly applied game design elements, however, may undermine
these basic psychological needs by the overjustification effect or through negative
effects of competition. Educators must, therefore, clearly understand the benefits
and pitfalls of gamification in curricular design, take a thoughtful approach when
integrating game design elements, and consider the types of learners and overarching
learning objectives.