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Joudaki Rad E, Kordnejad M, Taghvaei R, Boroon M. Designing, Implementing, and Evaluating a Snakes and Ladders Game for an Anesthesia Pharmacology Course. Iranian Journal of Medical Education 2026; 26 :123-133
URL: http://ijme.mui.ac.ir/article-1-5939-en.html
URL: http://ijme.mui.ac.ir/article-1-5939-en.html
Department of Anesthesiology, School of Nursing, Abadan University of Medical Sciences, Abadan, Iran. , shaefijr44@gmail.com
Abstract: (27 Views)
Introduction: Teaching pharmacology in anesthesia education is challenging because students need to understand complex pharmacological concepts and apply them accurately in clinical practice. Conventional lecture-based instruction may offer limited opportunities for active participation, critical thinking, and sustained knowledge retention. This way, student-centered approaches have received increasing attention in medical education. Among these approaches, game-based learning has emerged as a promising strategy for enhancing motivation, engagement, collaboration, and meaningful learning. Educational games can provide immediate feedback and promote active participation, making learning more engaging while reinforcing both theoretical knowledge and its clinical application. Although game-based learning has demonstrated beneficial outcomes across various medical disciplines, evidence regarding the use of Snakes and Ladders as an educational tool in anesthesia pharmacology remains limited. Therefore, this study endeavored to design, implement, and evaluate a customized Snakes and Ladders game integrated into an anesthesia pharmacology course and to examine students’ perceptions of the educational environment.
Methods: This quantitative educational intervention was conducted in 2025 using a single group design among undergraduate anesthesia students at Abadan University of Medical Sciences. Thirty-five students in the eighth and ninth academic semesters participated in the study. The intervention was implemented in four stages. First, students received preparatory educational materials and a brief review of essential pharmacological concepts. The rules and procedures of the educational game were then explained, and students were divided into five collaborative groups. A customized 100 square Snakes and Ladders board was developed, with each square containing educational activities, including multiple choice pharmacology questions, clinical scenarios, practical anesthesia related tasks, bonus and penalty activities, and forward or backward movements. The game was collaboratively developed by anesthesia faculty members, anesthesiologists, clinical instructors, and medical education specialists. The educational tasks increased progressively in difficulty across four stages, requiring students to demonstrate both theoretical knowledge and practical skills. Following the intervention, students’ perceptions of the educational environment were assessed using the validated Persian version of the Dundee Ready Educational Environment Measure (DREEM), which evaluates perceptions of learning, teachers, academic self-perception, educational atmosphere, and social self-perception. Data were analyzed using descriptive statistics and independent samples t tests.
Results: Thirty-five students completed the study. The mean age was 21.8 ± 1.2 years, and 80% of participants were female. The mean overall DREEM score was 137.2 ± 14.0, indicating a more positive than negative educational environment. Positive perceptions were observed across all five DREEM domains: perception of learning (31.2 ± 3.9), perception of teachers (28.7 ± 2.8), academic self-perception (26.8 ± 2.5), educational atmosphere (30.3 ± 3.4), and social self-perception (20.2 ± 1.4). No statistically significant differences were found in DREEM scores by academic semester (p = .54) or sex (p = .78). Qualitative feedback was consistent with these findings, with most students reporting increased motivation, classroom participation, teamwork, and concentration, as well as improved retention of pharmacological concepts. The integration of theoretical questions with practical anesthesia related activities was identified as a particularly valuable feature of the intervention. Some students recommended allowing additional time to address more challenging questions in future implementations.
Conclusion: The findings suggest that integrating a customized Snakes and Ladders game into anesthesia pharmacology education was associated with positive perceptions of the learning environment. The favorable DREEM scores indicate that students viewed learning, interactions with instructors, academic self-perception, and the educational atmosphere positively. These findings are consistent with previous research suggesting that game-based learning can promote motivation, active participation, collaboration, and knowledge retention in health professions education. Unlike conventional board games, the present intervention integrated pharmacological knowledge with authentic clinical tasks, enabling students to reinforce theoretical concepts while engaging with essential anesthesia related skills in an interactive setting. The absence of statistically significant differences in DREEM scores by sex or academic semester suggests that students across these subgroups reported similar perceptions of the educational environment. Several limitations warrant consideration. The single group design, relatively small sample size, and absence of a control group limit causal inference. Moreover, the DREEM measures students’ perceptions rather than objective learning outcomes or clinical competence. Future research could employ larger multicenter samples, controlled study designs, and objective measures of knowledge retention and clinical performance to further examine the educational effectiveness and longer-term impact of this approach. In conclusion, a customized Snakes and Ladders game offers a simple, low cost, and potentially useful strategy for creating an engaging learning environment in anesthesia pharmacology education. By combining theoretical content with practical clinical tasks, this approach may complement conventional teaching methods and could be adapted to other medical science courses that require the integration of theoretical knowledge and practical application.
Methods: This quantitative educational intervention was conducted in 2025 using a single group design among undergraduate anesthesia students at Abadan University of Medical Sciences. Thirty-five students in the eighth and ninth academic semesters participated in the study. The intervention was implemented in four stages. First, students received preparatory educational materials and a brief review of essential pharmacological concepts. The rules and procedures of the educational game were then explained, and students were divided into five collaborative groups. A customized 100 square Snakes and Ladders board was developed, with each square containing educational activities, including multiple choice pharmacology questions, clinical scenarios, practical anesthesia related tasks, bonus and penalty activities, and forward or backward movements. The game was collaboratively developed by anesthesia faculty members, anesthesiologists, clinical instructors, and medical education specialists. The educational tasks increased progressively in difficulty across four stages, requiring students to demonstrate both theoretical knowledge and practical skills. Following the intervention, students’ perceptions of the educational environment were assessed using the validated Persian version of the Dundee Ready Educational Environment Measure (DREEM), which evaluates perceptions of learning, teachers, academic self-perception, educational atmosphere, and social self-perception. Data were analyzed using descriptive statistics and independent samples t tests.
Results: Thirty-five students completed the study. The mean age was 21.8 ± 1.2 years, and 80% of participants were female. The mean overall DREEM score was 137.2 ± 14.0, indicating a more positive than negative educational environment. Positive perceptions were observed across all five DREEM domains: perception of learning (31.2 ± 3.9), perception of teachers (28.7 ± 2.8), academic self-perception (26.8 ± 2.5), educational atmosphere (30.3 ± 3.4), and social self-perception (20.2 ± 1.4). No statistically significant differences were found in DREEM scores by academic semester (p = .54) or sex (p = .78). Qualitative feedback was consistent with these findings, with most students reporting increased motivation, classroom participation, teamwork, and concentration, as well as improved retention of pharmacological concepts. The integration of theoretical questions with practical anesthesia related activities was identified as a particularly valuable feature of the intervention. Some students recommended allowing additional time to address more challenging questions in future implementations.
Conclusion: The findings suggest that integrating a customized Snakes and Ladders game into anesthesia pharmacology education was associated with positive perceptions of the learning environment. The favorable DREEM scores indicate that students viewed learning, interactions with instructors, academic self-perception, and the educational atmosphere positively. These findings are consistent with previous research suggesting that game-based learning can promote motivation, active participation, collaboration, and knowledge retention in health professions education. Unlike conventional board games, the present intervention integrated pharmacological knowledge with authentic clinical tasks, enabling students to reinforce theoretical concepts while engaging with essential anesthesia related skills in an interactive setting. The absence of statistically significant differences in DREEM scores by sex or academic semester suggests that students across these subgroups reported similar perceptions of the educational environment. Several limitations warrant consideration. The single group design, relatively small sample size, and absence of a control group limit causal inference. Moreover, the DREEM measures students’ perceptions rather than objective learning outcomes or clinical competence. Future research could employ larger multicenter samples, controlled study designs, and objective measures of knowledge retention and clinical performance to further examine the educational effectiveness and longer-term impact of this approach. In conclusion, a customized Snakes and Ladders game offers a simple, low cost, and potentially useful strategy for creating an engaging learning environment in anesthesia pharmacology education. By combining theoretical content with practical clinical tasks, this approach may complement conventional teaching methods and could be adapted to other medical science courses that require the integration of theoretical knowledge and practical application.
Type of Study: Original research article |
Subject:
Teaching Methods
Received: 2025/12/26 | Accepted: 2026/07/12 | Published: 2026/04/30 | ePublished: 2026/04/30
Received: 2025/12/26 | Accepted: 2026/07/12 | Published: 2026/04/30 | ePublished: 2026/04/30
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