# Are Serious Games an Effective Teaching Tool in Anatomy Education? A Systematic Review
## 1 Introduction  
Human anatomy is one of the main components of medical school curricula as well as the various clinical specialties. Medical and health science students should master both theoretical and practical knowledge of anatomy. Mastery of anatomy requires a thorough understanding of the systemic and spatial interrelationships of anatomical structures. Therefore, continuous innovation in anatomy teaching methodologies is essential to meet the evolving needs of medical students and the increasing complexities of clinical practice [1].  
Historically, the dissection of donated human bodies has been regarded as the standard for learning anatomy, supplemented with lectures and textbooks. Donated human bodymaterial enables the student to comprehend the three-dimensional concepts of organs and features of tissues and their spatial relationships. The biggest limitation of using cadavers as a learning tool is limited access, the financial burden of laboratory maintenance, and other logistical complexities [2]. Additionally, formalin fixed bodies cannot mimic living tissues' haptics, bio-mechanical properties, color, or texture, which limits their realism [2]. These challenges, coupled with the growing demand for skilled healthcare professionals, highlight the need for innovative teaching strategies that go beyond traditional methods [3].  
These challenges, alongside the increasing number of health programs and cohort sizes have compelled many medical schools to reduce or replace cadaveric dissection [4]. This shift has, in some cases, impaired the development of student's clinical skills [5; 6; 7]. Practical activities have been reduced to demonstrations of prosection rather than active dissection, emphasizing the need for alternative teaching modalities [8]. Consequently, the integration of educational technologies has gained prominence mainly for their ability to promote engagement and enhance the retention of anatomical knowledge [9].  
Among these technological innovations, gamification has been explored in anatomy teaching and learning. Games, particularly serious games designed for educational purposes, have received increased attention from healthcare professionals due to their vast potential for training and therapy [3; 10; 11; 12; 13]. Students, especially those immersed in digital environments and social networks, often find such tools engaging and aligned with their learning preferences [9]. When it comes to game-based learning, one might frequently come across similar terms with different meanings (i.e., gamification, serious games, non-serious games). A study highlighted the fine line between these terms. Gamification incorporates game elements (such as a leaderboard, points) in a non-gaming setting such as education [14]. In this case, there is no intention to create a game, while a serious game requires the recreation of a game for the purpose of learning (not entertainment). On the contrary, a non-serious game is having a game for the sake of entertainment [14].  
Despite their growing adoption, serious games in anatomy education face several limitations, including methodological constraints and study biases [1; 15; 16]. While existing studies have explored the potential of serious games in enhancing anatomy education, the evidence remains fragmented, and their collective role across different anatomy domains has not been systematically analyzed. Hence, this systematic review aims to address this gap by evaluating the effectiveness and utility of serious games in anatomy education, focusing on their ability to complement traditional methodologies and meet the evolving needs of health profession students.