Medical School, University of Pécs
Pécs, Baranya, 7624, Hungary
NCT Number: NCT07788183
TEACH_UP is a parallel-group randomized trial that evaluated whether adding a gamified design layer to a content-equivalent asynchronous faculty development course improved teaching self-efficacy, teaching orientation, engagement, course participation, and early teaching performance among medical educators at the University of Pécs Medical School. Participants were allocated to a gamified Moodle course or a standard Moodle course containing the same modules, learning objectives, assessments, and feedback. The gamified version added map-based progression, conditional release, experience points, badges, progress visibility, and a leaderboard. Outcomes included pre-post teaching self-efficacy and teaching orientation, post-course engagement, Moodle analytics, course performance, microteaching ratings, and a protocol-specified three-month follow-up survey.
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Notify Me18 year and older
All sexes
Interventional
Not applicable
Pécs, Baranya, 7624, Hungary
The TEACH-UP study was a single-center, parallel-group randomized controlled trial conducted within an existing asynchronous faculty development program at the University of Pécs Medical School. The study examined the incremental effect of adding a gamified instructional-design layer to a content-equivalent online course. The institutional program supports medical educators with teaching responsibilities and has professional relevance for academic progression. Although participation in the study was voluntary, the course was delivered in an authentic, workload-constrained faculty development setting.
The study was based on the premise that gamification may influence learning indirectly by making progress visible, providing immediate feedback, structuring challenge, and supporting perceived competence and autonomy. These mechanisms were expected to affect pacing, persistence, and behavioral investment in course activities. The purpose of the trial was therefore to determine whether gamification added measurable educational value beyond that provided by a well-structured standard online course.
Both study groups completed the same 10-module asynchronous program in the institutional Moodle learning management system. The two course versions had the same learning objectives, instructional content, module sequence, interactive activities, discussion opportunities, videos, formative quizzes, final assessment, and automated feedback. The standard version presented these components through a conventional Moodle interface. The gamified version added a map-based progression pathway, sequential and conditional activity release, experience points, badges, progress indicators, and leaderboard functionality. Selected supplementary materials were released conditionally according to quiz performance. The intervention was therefore designed to isolate the incremental contribution of the gamified layer while keeping the substantive educational content and assessment requirements consistent between groups.
Before trial launch, the study instruments were adapted for use in Hungarian through forward-back translation and interdisciplinary expert review. Cognitive interviews with a convenience sample of educators were used to assess clarity and contextual suitability. The two Moodle environments, survey implementation, activity tracking, and data-export procedures were also tested end to end, with minor linguistic and technical refinements made before participant enrollment.
Following confirmation of eligibility and electronic informed consent, participants were assigned to the gamified or standard course. Randomization used a reproducible, computer-generated, stratified fixed-total procedure with a prespecified random seed. Stratification was based on academic setting, teaching seniority, and sex. Allocation was approximately balanced within each stratum while maintaining the intended overall allocation ratio. The sequence was generated centrally and was not accessible to personnel involved in enrollment. Participants were aware of the course format they received. Raters contributing to the synchronous microteaching assessment were not provided with participants' allocation, although the self-reported components of the study were unmasked.
Study information, electronic consent, surveys, course activities, embedded assessments, and learning-management-system analytics were collected through institutional digital platforms. A synchronous microteaching activity provided an additional structured assessment of teaching behavior. Participants were subsequently contacted for a planned three-month follow-up. The follow-up was completed as part of the study protocol but was not included in the thesis or the current manuscript because of the time available for thesis analysis and reporting.
Data from the different sources were linked through coded participant identifiers and exported in de-identified form for analysis. The identification key was stored separately on an access-restricted institutional system. Analyses followed randomized assignment and used the available data for each measure without imputation. Baseline-adjusted models were used for measures collected before and after the course, while post-course-only, count-based, bounded, and clustered measures were analyzed using methods appropriate to their distribution and measurement structure. No interim analyses or stopping rules were used.
The study involved an educational intervention only and did not include a drug, biological product, medical device, diagnostic procedure, or other medical treatment.
Healthy volunteers accepted: Yes
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
A 10-module, self-paced faculty development course delivered through the institutional Moodle platform. Each module included interactive H5P content, a discussion activity, a short formative quiz with automated feedback, and a module-related video. The course incorporated a map-based progression pathway, sequential and conditional activity release, experience points, badges, visible progress indicators, and leaderboard functionality. Selected supplementary materials were unlocked according to predefined quiz-performance criteria. The course concluded with a cumulative knowledge assessment and a synchronous microteaching activity. Its learning objectives, substantive content, assessments, and feedback were identical to those of the standard course.
A matched 10-module, self-paced faculty development course delivered through the institutional Moodle platform. It contained the same learning objectives, substantive content, H5P activities, discussions, videos, formative quizzes, automated feedback, cumulative knowledge assessment, and synchronous microteaching activity as the gamified course. The modules were presented through a conventional Moodle interface without map-based progression, experience points, badges, progress indicators, leaderboard functionality, or performance-dependent gamified unlocking. Supplementary materials became available after completion of the relevant quiz regardless of the participant's score.
Time frame: At completion of the 10- to 12-week course
Mean score from items 1-11 of the 16-item Physician Teaching Self-Efficacy Questionnaire (PTSQ), representing items applicable across clinical and preclinical teaching contexts. Each item is scored from 1 to 5. The score is calculated when at least 9 of the 11 items are completed. Possible scores range from 1 to 5, with higher scores indicating greater teaching self-efficacy. Primary analysis: post-course score adjusted for baseline.
Time frame: At completion of the 10- to 12-week course
Mean score of the 11-item Conceptual Change/Student-Focused subscale of the 22-item Approaches to Teaching Inventory (ATI-CCSF). Items are scored from 1 to 5. The subscale score is calculated when at least 9 of 11 items are completed. Possible scores range from 1 to 5, with higher scores indicating a more student-focused, conceptual-change teaching orientation. Post-course comparison adjusted for baseline.
Time frame: At completion of the 10- to 12-week course
Derived Approaches to Teaching Inventory orientation index calculated as the Conceptual Change/Student-Focused mean score minus the Information Transmission/Teacher-Focused mean score (CCSF minus ITTF). Each subscale ranges from 1 to 5; therefore, the index ranges from -4 to +4. Higher values indicate a relatively more student-focused rather than teacher-focused orientation.
Time frame: At the post-course microteaching session, approximately 10 to 12 weeks after enrollment
Presenter-level score calculated by first averaging nine teaching-behavior items, each rated from 1 to 5, and then averaging the resulting scores across peer raters. Possible scores range from 1 to 5, with higher scores indicating stronger observed teaching performance.
Time frame: At completion of the 10- to 12-week course
Mean of all 19 Online Student Engagement Scale (OSE) items, calculated when at least 16 items are completed. Possible range 1-5; higher scores indicate greater online engagement.
Time frame: Throughout the 10-12 week course
For each matched course activity within each study arm, the activity-view rate was derived from the total number of Moodle page views, using the number of unique users accessing the activity as the exposure denominator. The measure ranges from 0 with no fixed upper limit; higher values indicate more recorded activity access per user.
Time frame: 3 months after Microteaching completion (6 months from enrollment)
Mean score from items 1-11 of the Physician Teaching Self-Efficacy Questionnaire (PTSQ). Each item is scored from 1 to 5. The score is calculated when at least 9 of the 11 items are completed. Possible scores range from 1 to 5, with higher scores indicating greater teaching self-efficacy.
University of Pecs
Other
TEACH-UP - Teaching Engagement and Competency Enhancement Through Asynchronous, User-Centered Pedagogy: A Quality Improvement Initiative in Medical Faculty Development
Acronym: TEACH-UP
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