A pilot study: Influence of free versus cued recall questions on medical student utilization, effectiveness, and perception of pharmacology educational games
Authors: Lee Jason S , Cowan Melissa , Gorman A. Laurel 
Published: November 2023

Although educational games have been employed as engaging learning tools designed to reinforce and teach basic science concepts in healthcare education, research is limited on which elements are most beneficial to learning. The aim of this study was to compare cued and free recall style questions in pharmacology educational games to determine which is better. We surveyed students to determine perceived educational value to second year medical students. Forty‐four University of Central Florida College of Medicine medical students, at the end of their second year, were administered a multiple choice question (MCQ, N=12) pre‐test to determine their baseline knowledge of pharmacology. Students were then provided an electronically distributed Jeopardy‐style free recall game and a cued‐recall Trivia‐style MCQ game similar to “Who Wants to be a Millionaire?”. Immediately after completing the second game, students completed a post‐game assessment with similar difficulty pharmacology MCQs (N=12) different from the pre‐test and a survey with a 1–5 Likert scale (1= strongly disagree to 5=strongly agree). While performance on the post‐game assessment increased for both groups, a significant performance increase (p=0.04) was noted for questions on topics covered in the Trivia‐style game, but not the Jeopardy‐style game. Survey data revealed that students enjoyed the games, with 74% of participants indicating they would use pharmacology educational games for self‐study, especially in situations where structured didactic time was not allotted. A majority perceived that the games were engaging and promoted active learning of pharmacology. Students preferred the Trivia‐style cued recall over the Jeopardy free recall because the MCQ structure was similar to their exams, and they found reminders of clinical relevance embedded into either type of educational game rewarding. Our students appeared to benefit more from the Trivia‐style game, but this may have resulted because the game gave them practice in answering MCQ‐style questions similar to those on the post‐game assessment. Thus, the increase in post‐test performance in this group may have resulted from a “testing” effect so we can't conclude definitively that cued recall is better than free recall for learning until an additional study is conducted with a different post‐assessment method for determining learning. In conclusion, this preliminary study supports that students desire engaging learning tools and will utilize games for active learning if the concepts covered are clinically relevant and provide beneficial practice for retrieval‐based learning. Our pilot study shows that pharmacology games, regardless of recall structure, may be a valuable tool for promoting active learning and enhancing student interest In pharmacology, a challenging field where knowledge is constantly expanding. Further, the electronic distribution of such games could make them beneficial to clerkship students who require access to pharmacotherapeutics information and efficient pharmacology review learning tools during hospital and distant site rotations.