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Clin Exp DermRCT

Gamification of dermatology diagnostics training

a nationwide, randomized, controlled trial of 34,556 cases.

Kristensen SIP, Ternov NK, Nervil GG, Andersen SAW, Guitera P, Braun RP, Konge L, Navarrete-Dechent C, Hölmich LR, Frendø M

Clinical and Experimental DermatologyIn the feed 17 Sep 2026, published online 17 Sep 2026, issue 2026 Sep 17, added to PubMed 17 Sep 2026

Topics: Skin cancer & tumors

Abstract

BACKGROUNDSkin cancer incidence is rising, as is the focus on efficient, evidence-based diagnostic training. However, proficiency in skin cancer diagnosis requires years of practice, and methods to accelerate learning are therefore necessary. Gamification-integration of game-like mechanics-is a promising method.

OBJECTIVESEvaluating the effects of gamification-in the form of leaderboards showing participants' ranking-on training amount and skills acquisition in medical students, through directed, self-regulated, virtual training.

METHODSIn a nationwide randomized controlled trial, participants were randomized to either the gamification or control group, both of which had access to a quiz-based dermatology diagnosis training platform. The gamification group received a daily leaderboard showing rank, based on points earned through training. Diagnostic skills were assessed via validated 12-case pre- and posttests. Data were analyzed using linear mixed models and t-tests.

RESULTSSeventy-one participants were included; 34,556 assessments were completed. The gamification group trained 3.3 times as many cases as the control group (785 [95% CI: 437-1,134] vs. 240 cases [95% CI: 154-325], p<0.01). There was no significant difference in diagnostic skill improvement (0.12 points of 12 [95% CI: -0.7-1.3] vs. 0.65 points of 12 (2.2% and 14.3% relative to baseline, respectively) [95% CI: -0.2-1.5], p=0.40).

CONCLUSIONSGamification led to substantially increased training volume, without improving skills acquisition. This may be explained by a shift in focus towards leaderboard placement, diminishing motivation to internalize learning content. Improved understanding of evidence-based dermatology training-i.e., the most efficient methods for reaching proficiency-is needed and requires further large, randomized trials.

Abstract from PubMed

PMID 42752589 · DOI 10.1093/ced/llag384