PharmaQuest: a culturally-localized mobile game enhancing cardiovascular pharmacology learning among Iranian health professions students: a quasi-experimental controlled trial

Gamification has gained attention as a pedagogical strategy to enhance engagement and learning in medical education. However, evidence from non-Western contexts, particularly the Middle East, is scarce. This study evaluated the effectiveness of a culturally-localized mobile game (PharmaQuest) in improving cardiovascular pharmacology learning among Iranian health professions students. A quasi-experimental was conducted among 344 undergraduate students (medical, nursing, anesthesiology, and laboratory science) at Jahrom University of Medical Sciences in Spring 2024. Participants in the intervention group received lectures plus PharmaQuest (a Farsi-localized app with 10 levels of cardiovascular pharmacology content), whereas the control group ( n = 325 from the previous year) received lectures only. The primary outcome was immediate recall via a 10-item MCQ test (scored 0-100). Secondary outcomes included usability (GUESS-18, PSSUQ), motivation (TAM-based survey), satisfaction, and behavioral engagement (app analytics). Data were analyzed using t-tests and ANCOVA, with 95% CIs and Cohen’s d reported. Intervention group MCQ scores were significantly higher (mean 85.3 ± 10.2) than controls (68.4 ± 12.1; mean difference 16.9, 95% CI 14.2–19.6, p < 0.001, Cohen’s d = 1.02), representing a 23.7% increase. Usability (GUESS-18: M = 5.8/7 ± 0.9, p < 0.001) and satisfaction were high, with 82% preferring gamification. Motivation constructs were positive (e.g., perceived usefulness M = 3.75–3.98/5), though behavioral intention was moderate (M = 3.36–3.82/5). Students spent 8.2 ± 3.1 h on the app, with 92% completing all levels. Nursing students showed the largest gains (d = 1.2). PharmaQuest significantly improved cardiovascular pharmacology recall and engagement. Culturally adapted gamification is feasible and effective in non-Western contexts. Future studies should assess long-term retention and clinical application.