¹Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Studiendekanat, Düsseldorf, Germany

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Background and research question: Gamification enhances motivation, diagnostic competence, and engagement in medical education. Inspired by the clinical case discussion of the New England Journal of Medicine and the Paul-Ehrlich-Contest, the course “Diagnosis - PBL” was developed to integrate peer teaching, teamwork, and competition into diagnostic learning, fostering collaborative decision-making and expanding students’ knowledge.

Methods: The “Diagnosis - PBL” course is a 90-minute, weekly, open-format session for medical students from the 5^th semester onwards. Up to 20 participants per session are guided by a senior medical student as a tutor. The concept is based on Problem-based Learning (PBL) to encourage active discussions and decision-making. The course structure, inspired by the Paul-Ehrlich-Contest, a prestigious competition for medical students in Germany, Austria and Switzerland, consists of three components:

• Visual dagnosis (30%) – Teams identify diagnoses from clinical images using a buzzer system.
• Case-based diagnostics (50%) – Teams analyze cases, request diagnostic tests, and lose points for unnecessary investigations.
• Clinical discussion (20%) – Collaborative discussion of findings and differential diagnoses.

The course was implemented in the skills lab of the Medical Faculty of Heinrich Heine University, Düsseldorf. The evaluation in winter semester 2023/24 included 43 participants with a response rate of 60% (n=26). The assessment focused on knowledge transfer, learning scope, and satisfaction. Due to its success, the course is now part of an elective module.

Results:On average, 12 students attended each session, indicating high engagement. The evaluation confirmed the effectiveness of gamification in fostering teamwork and improving diagnostic reasoning. Free-text responses highlighted that the competitive approach increased motivation and encouraged better preparation. One participant noted: “The competitive format spurred my ambition and motivated me to learn beyond regular coursework.” Students reported that the course mirrored clinical decision-making and strengthened their diagnostic skills. The PBL format supported structured differential diagnoses.

Discussion and conclusion: The development of “Diagnosis - PBL” demonstrates that combining gamification, Problem-based Learning, and competitive elements effectively enhances diagnostic competence. Repeated participation highlights sustained motivation and learning success. Peer teaching benefits both tutors and participants by reinforcing knowledge retention. Integrating learning psychology principles enhances intrinsic motivation and learning outcomes. Future iterations should focus on students from the 7^th semester onwards to integrate clinical experience. Due to its positive evaluations, curricular integration could be considered to enhance diagnostic training.