Student perceptions of effectiveness, satisfaction, and active participation with online gamification in health sciences education

Abstract

This study examined how perceptions of engaging learning, satisfaction, and perceived effectiveness relate to active participation in gamified online courses among health sciences students. A cross-sectional observational study was conducted with 196 Peruvian university students enrolled in Ethics, Health Prevention and Promotion, and Health Management courses during the 2023–2024 academic semesters. Data were collected through a structured digital questionnaire and analyzed using descriptive statistics, chi-square tests, t-tests, and multiple regression analysis. Students reported high levels of active participation (M = 4.30, SD = 0.67) with no significant demographic differences. Regression analysis showed that perceived engaging learning was the strongest predictor of active participation (β = 0.398, 95% CI 0.265–0.532, p = 0.001), followed by general satisfaction (β = 0.128, 95% CI 0.032–0.223, p = 0.009). Participation was also associated with perceived improvements in knowledge retention (p = 0.001) and problem-solving (p = 0.032). Grounded in motivational and engagement theories, including Self-Determination Theory, these findings suggest that intrinsically engaging and satisfying learning experiences may play a central role in fostering behavioral engagement in gamified online environments, highlighting the importance of designing activities that support students’ motivational and experiential needs in health sciences education.