pan class="ff1 ls1 wsa">learners to “perform activities that they
were unable to perform without this support” (Merrienboer,
Clark, & Croock, 2002: p. 54). The support, in the form of in-
terventions, can be through the educators (e.g., teacher, tutor) or
by other means such as assistance mechanisms built into digital
learning resources (e.g., feedback, just-in-time help).
Digital games whose structures are competitive, utilize con-
tent information as currency (or a weapon) in gaming contexts,
to motivate and encourage players to battle for intellectual su-
premacy (Herz, 2002). Motivation, when applied to learning
systems, is defined as “the process by which we consciously or
unconsciously allocate working memory resources” (Brooks &
Shell, 2006: p. 17). Motivation leads to student engagement
which is of paramount importance in any effective learning
The Game Project
There is a general assumption that skills and knowledge de-
veloped in first year will be transferable to other academic con-
texts and real life situations, but, students are often unable to
identify these links and apply their skills and knowledge into
new domains (Britton et al., 2005; Scott, 2005; Rebello et al.,
2007). The transfer of core skills can occur under particular
learning conditions supported and enhanced by curriculum
design and specific pedagogical objectives (Justice, Rice, &
Warry, 2009; Lobato, 2008). The game project involved the
development and implementation of an online interactive game
(Alien Tissue II) to enable students to link content between
successive units in the first year of their degrees. The method-
ology of the online game allows for a structured progression by
linking and extending foundation knowledge with the increas-
ing complexity of the curriculum content. Currently there exists
no literature on the use of DGBL resources to link and extend
this foundation knowledge and/or to produce positive learning
Students studying Health Science based degrees (including
Exercise Science, Biomedical Science, and Environmental
Health) and, some Education and Science degrees, study a Cell
Biology unit in semester one. This unit is a prerequisite for the
semester two units, Anatomy & Physiology 1 and Microbiology
and Health. The online game incorporates content from the
above units in a tiered game system to engage students in both
learning and retaining the unit material, and in recognizing and
applying cross-unit content. The game is interspersed progres-
sively with the introduction of new and more challenging con-
cepts, thus allowing the combination of experiential and prob-
lem based learning methodology to create a balance between
student boredom and student challenge, motivation and en-
gagement. Alien Tissue II also includes a suite of single play er
games (Appendix 1) designed for students to use for quick re-
The game is currently written using a combination of perl,
html and java script and is compliant for students with disabili-
ties who use Dragon or Jaws software for computer access. The
content of each specific unit (i.e., Cell Biology, Anatomy &
Physiology 1 and Microbiology & Health) is delivered in the
game using multiple choice questions (MCQ). The MCQ’s are
written at differing orders of difficulty based around the do-
mains of Bloom’s taxonomy of learning (Bloom & Krathwohl,
1956). This taxonomy is a framework for organizing learning
objectives related to curriculum development and assessment.
The content of the MCQ’s in the game varies from simple
knowledge recall from the long term memory, to combinations
of recall and/or application and/or analysis, evaluation and
synthesis requiring both short and long term memory. Research
suggests that the MCQ format, when written according to the
higher levels of Bloom’s taxonomy, offers comparable reliabil-
ity and learning outcomes to the short answer format (Bacon,
2003; Selby, Blazey, & Quilter, 2008; Zheng, Lawhorn, Lum-
ley, & Freeman, 2008).
Feedback is available for the majority of the questions in the
game. The content of the foundation MCQ’s is linked to similar,
but more complex content areas throughout the first year units.
This linking, forms part of the feedback as the student pro-
gresses through related curriculum content. The feedback is
designed as a help system (scaffolding).and is provided after an
answer to an individual question. A study by Sweetser and
Dennis (2003) involving first year psychology students, dem-
onstrated that computer games used as a learning resource are
improved by the “addition of a help system that provides in-
formatio n to the us er at th e t ime tha t it is m ost requ ired ” (p . 4 9).
The game is designed to reward students for demonstrating
and applying knowledge. The rewards increase in value ac-
cording to the difficulty, application and linking of the concep-
tual knowledge which is required to correctly answer individual
questions. There is a reward system for certainty of using a
correct answer and the rewards are embedded in specific sce-
narios—Appendix 2 for an example of a student playing Alien
Tissue II. In Cell Biology and Anatomy & Physiology 1, the
scenario involves the prevention of mutation in cell lines. In
Microbiology & Health, the scenario is thwarting an invasion
by an alien microbe. The rewards include ATP (a form of en-
ergy currency), immune cells, enzyme levels and mutation re-
sistance. These rewards increase the strength of the player
against attack from another player, which is one of the interac-
tive components of the game.
Copyright © 2012 SciRes. 763
A hard copy anonymous questionnaire, containing both
closed and open-ended questions, was used to survey the use of
the game by students enrolled in Anatomy & Physiology 1. Of
the 25 questions in the questionnaire, the results of nine closed
and two open-ended questions are presented and discussed.
Ethics approval for this questionnaire was granted by the Tas-
manian Health and Medical Human Research Ethics Committee
(application number HOO10216).
Introductio n of the Game to the Stud ents
Students in Anatomy & Physiology 1 were introduced to the
game in dedicated computer laboratory sessions in the second
week of semester two. All students had completed a Cell Biol-
ogy unit at UTas in semester one of the first year of their un-
dergraduate degree.
Study Sample Demo graphics and Data Collection
First year students enrolled in Anatomy & Physiology 1 on
the Launceston campus of the University of Tasmania (UTas)
were asked to complete a questionnaire during tutorial time in
the thirteenth week of semester two. The cohort comprised 311
students (154 males, 157 females) enrolled in the first year of a
UTas undergraduate degree in the Faculty of Health Science,
Faculty of Education, Faculty of Business or Faculty of Science,
Engineering and Technology. Students gave their informed
consent and all responses were anonymous. The students were a
varied cohort, representing ten different degree courses. The
cohort comprised a mixture of Grade 12 school leavers, mature
aged students and students from interstate and overseas. The
overseas students comprised approx. 7.5% of the cohort. The
age range was 18 to 64 years with an average age of 22 years.
Only 18% of the cohort were 25 years of age or older.
The questions were designed to obtain a variety of informa-
tion: general demographic data; general computer use; fre-
quency of game access; opinion regarding the use of a digital
game as a learning tool; perceptions of knowledge recall from
Cell Biology; and perception of transfer of learning across three
core first year modules, Cell Biology, Anatomy & Physiology 1,
and Microbiology & Health. The eleven specific questions used
to gather responses for this study are displayed in Table 1.
Students’ perceptions of knowledge recall and transfer of
learning were obtained via guided, closed questions within the
questionnaire (Table 1). Transfer of learning was not quantita-
tively measured because controversy remains regarding the
methodology used to gather such information, and in fact, about
what parameters are actually being measured (Barnett & Ceci,
2002; De Corte, 2007; Lobato, 2006; Rebello et al., 2007).
Results and Discussion
Results from this study were evaluated using a qualitative
research methodology including descriptive statistics and phe-
nomenology. Data regarding gender and degree were collated
according to commonality of response and presented as rudi-
mentary summations about the sample cohort and their respec-
tive responses. Some of the interpretations are subjective in
nature, particularly those based around the open-ended ques-
tions. Whilst phenomenology usually relies on in-depth interns
Table 1.
Questions analyzed in this studya.
Question 1What degree are you currently enrolled in?
E3J M3G M3H M3L M3P M3Q M3R Other
Question 2Are you male or female?
Male Female
Question 4Did you revisit the game? If so, how many times?
No 1 - 2 3 - 5 >5
Question 7Did you enjoy playing the game?
Yes No Unsure
Question 13Do you think that the o nl i ne game has helped you t o r ecall
cell biology knowledge?
Yes No Unsure
Question 14
Now that y ou have play ed the game, can you see content
links betwe en cell biology and anatomy and physiology
and/or microbiology?
Yes No Unsure
Question 17Did you enjoy the interactive aspects of the game (i.e., infect
option, message fun ction)?
Yes No
Question 20What did you like most about the game?
Question 21What did you like least about the game?
Question 22Do you find the game an effective t ool for revision
Yes No Unsure
Question 24Do you enjoy pl aying computer games outside university
Yes No
Note: aThe full questionnaire comprised 25 questions.
(Hansen, 2006). This study evaluated results from 161 respon-
dents. The overall mean age of the total cohort (311 students)
was 22 years. This suggests that the game effectively targeted
the “digital natives” (Van Eck, 2006c) within our student co-
Student Feedback on the Game
One of the aspects of this study was to determine if the stu-
dents themselves could identify whether or not the game as-
sisted them with foundation knowledge recall and making links
between unit material and concepts. Results of the closed ques-
tions (questions 13 & 14) revealed that a majority (77%) of the
respondents recognized that the game had improved their abil-
ity to recall foundation knowledge and to use it in a related
context. The directed nature of the questions did not seem to
influence the students’ responses because answers to the
open-ended question about what respondents most liked about
the game (question 20), supported their answers to questions 13
and 14. For example, one respondent agreed the game had
helped with recall and making the links between units and
commented the game was “More than just regurgitating infor-
mation”. Another respondent on the other hand, thought the
game helped make the links between units but didn’t help with
content recall. These answers corresponded with his opinion
that the game “helps relate cell bio to anat & physic”. A small
number of respondents (n = 9) thought the game was useful for
Cell Biology content recall but were either unsure if it helped
make content links, or thought that it didn’t. These respondents
Copyright © 2012 SciRes.
all commented that the game either helped with revision or to
recall Cell Biology content.
Impact on Student Learnin g Outcomes
At present, the conventional measure of transfer of learning,
is the students’ ability to be successful in their assessments and
ultimately to graduate from university. The result of this study
suggests that the DGBL increases knowledge recall and transfer
of learning in Anatomy & Physiology 1. Student learning out-
comes were enhanced in the unit when the DGBL was available
as a learning resource, as shown by end of semester examina-
tion results. The average theory exam result was 52.3% when
the resource was available, compared to 48.3% in the year prior
to its implementation. It was also noted that an average theory
exam result of above 50% was recorded for this unit when the
DGBL was available. This had not been observed in previous
years. The theory exam contains both MCQ and Short Answer
questions (SA). In comparing MCQ and SA sections; there was
an improvement in the MCQ section compared to the SA sec-
tion of the theory exam. When the DGBL was available, stu-
dents averaged 62.8% in the MCQ section compared to 57.7%
in the previous year. However, only a slight improvement was
observed in the SA section (48.2% with the DGBL, compared
to 46.9% without the DGBL). As the DGBL is MCQ based, it
is apparent that it assists knowledge recall in this form of sum-
mative examination and one respondent stated that they liked
the game because it “was handy for revising for multiple choice
These increases in students’ examination scores also need to
be considered in the context of this specific student cohort and
any other pedagogical methodologies and platforms changed
within the unit, such as the incorporation of Peer Assisted
Study Sessions (PASS), which were also introduced into
Anatomy & Physiology 1. Further analysis of the student co-
hort performance still needs to be compared across all first year
units to determine if there are other factors involved in the im-
provement of their learning outcomes.
One of the aspects of this study was to determine if the stu-
dents themselves could identify whether or not the game as-
sisted them with foundation knowledge recall and making links
between unit material and concepts. 75% of respondents found
that the game helped them recall cell biology knowledge whilst
70% agreed that it enabled them to identify content links be-
tween related units of study. This was also supported by the
students’ responses to the open-ended questions about what
they most liked about the game. For example, one respondent
liked the game because the “game helped me to recall things
done in past units and link them to the present ones”. Similarly
another respondent found that the game “… reinforced material
learnt”. Furthermore, questionnaire responses indicated that the
resource did have a positive impact on student learning as one
respondent liked the game because it “helped work out what I
did and didn’t know”, while another respondent stated that “it
helped to recall info and enforce (sic) confidence in knowledge
of material”. Similarly, another respondent found the game to
be “a different/motivating way of learning and with the imple-
mentation of the hint-help—I learnt a lot”. These responses
indicated that the DGBL has a positive impact on student
Whether or not respondents played other computer games did
not seem to influence their enjoyment of this game. In fact,
89% of respondents indicated that they enjoyed the game even
though only 49% enjoyed playing computer games outside of
their university studies. Respondents liked the game because it
was “fun and interactive” and “it was a fun way of learning”.
One respondent also stated that “it provided learning in an en-
joyable environment, learning by playing a game”. The game
also incorporated some interactive components to engage stu-
dents and 81% of respondents enjoyed the interactiveness of the
game. This seemed to be reflected by the gender of the indi-
vidual as male respondents were fairly consistent about liking
the game and enjoying playing other computer games. The
female respondents however, admitted to enjoying the game to
a greater degree than would be expected, considering the very
small proportion who normally played other computer games.
Female players typically liked the game because “it was fun
and educational at the same time”. They were able to “gain
knowledge in an enjoyable way” and “being able to infect other
players and build resistance” was also favored by some of the
female pl ayers.
These results suggest the format of the game was such that it
not only maintained the interest of habitual computer game
users (mainly male in this instance) and engaged student learn-
ing but, it also succeeded in capturing the interest of those stu-
dents (mainly female in this study) less inclined to engage in
game playing. Gender is an issue in DGBL, as to whether digi-
tal games are a “boy toy” or, indeed, if females will use them to
the same degree (Prensky, 2001b). In addressing the issue of
whether males and females may prefer differently styled games,
it is suggested that whilst some females might prefer “interac-
tion” rather than “action”, that fundamentally, “an exciting
game is an exciting game”, and gender is not an issue if the
games are engaging and enjoyable (Prensky, 2001b). Paraskeva,
Mysirlaki and Papagianni (2010), in discussing the develop-
ment of educational multi-layer online games, states that “fe-
males enjoy games with characteristics which they consider to
be fun, such as games played against the computer, puzzles and
quiz games” (p. 500).
Summary of Findings and Future Directions
The outcomes which support student use of a game format
include emotional engagement, motivation, challenge and a
feedback scaffolding system. The results of this study, contri-
bute significantly to the body of literature about the use of digi-
tal game resources for transfer and application of foundation
knowledge, particularly at the level of the first year tertiary
experience. The game has succeeded in engaging and motivat-
ing both “digital natives” and those new to game technology,
enabling them to acquire and transfer knowledge with positive
learning outcomes. We acknowledge that this study worked
within a relatively defined cohort of students in terms of social
and academic environment. Future studies encompassing a
more diverse student sample should support and strengthen the
validity of these findings and permit extrapolation to a wider
Currently the game supports teaching and learning in three
first year units (Cell Biology, Anatomy, & Physiology 1, Mi-
crobiology) which are common to a number of Health Science
undergraduate degrees. Development of the game to include
support for three additional units is currently underway, with
funding being sought to develop this. It is envisaged that ulti-
mately the game will be developed sequentially to include
Copyright © 2012 SciRes. 765
modules which support and link second and third year under-
graduate units, particularly in the Faculties of Health Science
and Education. The resource also has the potential to be ex-
panded into a generic game based tool for interdisciplinary use
across faculties. However, Van Eck (2006c: p. 18), cautions
against arguing that “all games are good for all learners and for
all learning outcomes”. He emphasizes that research is needed
into understanding “why DGBL is engaging and effective” and
the importance of taking a realistic direction for “when, with
whom, and under what conditions”, digital games can be suc-
cessfully incorporated into “the learning process to maximize
learning potential”. In addition, Krotoski (2005) believes that
whilst today’s students are accepting digital games as a power-
ful learning tool, it may be a challenge to convince the educa-
tors who do not yet embrace this technology.
Ultimately, the progressive transfer of foundation knowledge
between units, and its application in more complex contexts, is
the aim of all higher education institutions. Based on the results
of our study which used a DGBL resource in first year units,
there are indications of positive learning outcomes in students’
recall, application and transfer of knowledge. A digital game
based resource, which is creatively designed to engage and
motivate students whilst simultaneously increasing their learn-
ing outcomes, is a valid and valuable tool in the portfolio of
teaching and learning resources, particularly at the first year
The authors would like to acknowledge the University of
Tasmania for funding this project.
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Appendix 1. Screen Capture of Alien Tissue II and Single Player Games Available at
Copyright © 2012 SciRes.
Appendix 2: Example of a Student (Username:
Golgi) Playing Alien Tissue II
Golgi logs onto gameselects Anatomy and Physiology 1
Status: 120 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 11
Click on Earn Credits, Quiz Credits
Click on New Question:
Q. 5) Which anatomical plane divides the body into equal
left and right halves?
a) transverse
b) oblique
c) frontal
d) parasagittal
e) median Click on answer e)
Click on Certainty: High
Feedback: This plan is also referred to as the mid-sagittal
12 ATP earned. Bank ATP
Status: 132 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 11
Click on Next Question
Q. 39) Which of the following cell organelles would be most
important to epithelial cells whose primary function is secre-
a) Lysosomes
b) Peroxisomes
c) Golgi apparatus
d) Cilia
e) Desmosomes Click on answer c)
Click on Certainty: Medium
Feedback: Golgi apparatus package and process molecules
into vesicles for export from the cell.
Links to the following Cell Biology Lab Questions:
CBQ 11) A hormone secreting cell would be expected to
have a large number of:
Answer—Golgi apparatus and secretory vesicles distributed
throughout its cytoplasm
CBQ 39) The functions of the Golgi apparatus include:
Answer—synthesis, storage, alteration and packaging
CBQ 118) Human pancreatic cells that are active in peptide
hormone secretion would contain many:
Answer—Golgi bodies
9 ATP earned. Bank ATP
Status: 141 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 11
Click on Next Question
Q.152) The thick myofilaments in skeletal muscle are com-
posed of the protein:
a) myosin
b) keratin
c) actin
d) troponin
e) tropomyosin Click on answer c)
Click on Certainty: Medium
Incorrect. Correct answer is a)
Feedback: The myosin (thick) and actin (thin) myofilaments
in individual sarcomeres enable a skeletal muscle to contract.
Links to the following Cell Biology Lab Question:
CBQ 8) Actin and myosin in muscle cells are best classified
Answer—movement proteins
-9 ATP earned. Bank ATP.
Status: 132 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 11
Click on Earn Credits
Click on Infect Credits
Select player to infect: Zeppity
Report: You Lost
The results of your attack on Zeppity in Lab 2
Your attack strength was 54 units
Zeppity had a strength of 92 units
ATP lost: 34 ATP
Immune cells lost: 1
Immune cells destroyed: 1
Status: 98 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 10
Click on Updates
Select Immune cells: 1
(costs 50 ATP)
Status: 48 ATP, Enzyme Levels: Average, Mutation resis-
tance: Low, Immune cells: 11
Click on Exit
Select Exit Game and Logout