Effect of Choose-Your-Own-Adventure (CYOA) Activities on Pharmacy Student Knowledge

Objective: Many strategies are used in pharmacy education to maintain student engagement through active learning. Gamification, such as the choose-your-own-adventure activity (CYOAA), is one such method. The purpose of this study was to assess improvement in clinical knowledge and retention after the implementation of CYOAA. Methods: Two CYOAAs were designed and implemented within second-year pharmacy courses. One activity was on venous thromboembolism (VTE) and the other on chronic obstructive pulmonary disease (COPD). Students completed a six question prequiz and postquiz for both activities mapped to core learning objectives and four similar but more difficult questions on corresponding exams. After the CYOAAs, the students completed a reflection and perceptions survey. Results: Seventy-five students completed the VTE CYOAA and 77 completed COPD CYOAA. Over the three time points, there was a significant decrease in the mean assessment scores on the VTE activity (68% to 65% to 40%) versus a significant and sustained increase in mean assessment scores on COPD (62% to 83% to 85%). Of the 36 and 33 students who completed the postsurvey, the majority agreed or strongly agreed that they preferred CYOAA to traditional cases and that the activities improved their knowledge, critical thinking skills, and confidence in clinical decision-making. Conclusion: There was a mixed result in the mean assessment scores, with an increase seen with the COPD CYOAA and a decrease with VTE, as well as positive perceptions for VTE and COPD, indicating that this classroom innovation is well-liked and may improve knowledge outcomes.