Publication:

The integration of gamification strategies within competency-based otorhinolaryngology residency training: a comprehensive analysis of pedagogical shifts, technological implementations and professional outcomes in the U. S. medical education system

Postgraduate medical education is transitioning toward a structured competency-based medical education (CBME) framework, utilizing ACGME Milestones 2.0 and Entrustable Professional Activities (EPAs) to objectively measure resident progression from novice to expert. Objectives were to evaluate the integration of gamification strategies, applying game-design elements within non-game settings, in otorhinolaryngology residency, specifically analyzing their impact on learner engagement, operative technical proficiency, and professional outcomes. A comprehensive analysis evaluated the implementation of digital pedagogy (e.g., podcasts, microblogging), workplace-based assessment platforms (EMYWAY), cognitive judgment tools (SICKO), and immersive simulations (VR/AR/MR) for core surgical skills acquisition. Educational preferences are shifting toward digital resources; notably, residents engaging in gamified discussions on platforms like Twitter increased their ABSITE percentile rank by an average of 13.7%. Digital assessment tools such as EMYWAY foster a shared understanding of competency between faculty and trainees (r=0.531). Furthermore, VR simulations for emergency procedures and temporal bone surgery significantly enhance procedural accuracy, with VR cricothyrotomy improving performance in 92% of participants. Tools like SICKO also effectively differentiate surgical expertise levels (p=0.001). Gamification effectively modernizes surgical training by bridging the gap between theoretical knowledge and operative mastery. Strategic recommendations emphasize integrating validated simulators and AI-driven adaptive learning into weekly training to support objective entrustment decisions.