Short-term knowledge gains following passive, active, and gamified instruction in medical microbiology and immunology: a repeated-measures study

Medical education has historically relied on lecture-centric models despite evidence supporting learner-centered approaches. However, direct comparisons of Passive, Active, and Gamified instruction within the same student cohort remain limited in podiatric medical education. I compared these three instructional methods in a first-year podiatric Medical Microbiology and Immunology course. A total of 54 first-year podiatric medical students participated in a within-subjects repeated-measures study comparing Passive, Active, and Gamified instructional methods across six unique content sessions. Short-term knowledge gains were assessed using pre- and post-session quizzes. Complete-case data from 43 students were analyzed using repeated-measures ANOVA. From the complete-case analysis ( N = 43), Active learning was associated with the highest mean quiz-score gain (1.64), followed by Passive (0.98) and Gamified instruction (0.65). A one-way repeated-measures ANOVA identified significant differences in short-term knowledge gains across instructional conditions, F(2, 84) = 10.16, p < 0.001, partial eta squared = 0.20. Pairwise comparisons showed greater short-term knowledge gains during Active learning than during Gamified ( p < 0.001) and Passive instruction ( p = 0.012), with no statistically significant difference between Passive and Gamified instruction ( p = 0.447). In this cohort, Active learning was associated with greater short-term quiz-score gains than Passive or Gamified instruction. These findings support further evaluation of structured Active learning approaches in podiatric medical education.