Health systems and public health learning through partnership: Co-designing a game-based assessment with South African medical students
1
Health Systems and Public Health, Stellenbosch University, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1103
ABSTRACT
BACKGROUND:
Strengthening health systems and public health (HSPH) learning is essential in South Africa, where inequity and a quadruple burden of disease require graduates who can apply systems thinking in complex care environments.1 Game-based learning offers an active, scalable approach to reinforce HSPH concepts. We report a student–staff partnership to co-design a game-based assessment for fourth-year medical students.2-4
METHODS:
A partnership team (five undergraduate medical students, two interns, and an academic lead) co-designed a 25-minute, station-rotation assessment delivered to a cohort of under 300 students in a fourth-year module following clinical rotations. Games were selected and adapted through iterative prototyping and feasibility testing to ensure alignment with priority health systems and public health concepts and suitability. The final Game Day comprised four rapid, facilitator-led games with a points system: (1) Bingo using short-answer questions; (2) Jubilee, a movement-based yes/no/maybe decision game; (3) Rapid Fire, a timed team-response game using flags; and (4) Connections (a categorisation task using projected terms).
RESULTS:
The format enabled high-throughput participation, repeated retrieval practice, peer discussion, and immediate feedback on health systems and public health concepts within a constrained timeframe. Students engaged competitively and collaboratively, and facilitators could quickly identify misconceptions and address knowledge gaps. Practical adaptations (simplified rules, pacing cues, and removal of one game) were necessary to maintain fidelity to time and group-size constraints.
CONCLUSIONS:
Co-designed, low-resource, rapid-cycle games can operationalise health systems and public health teaching at scale in undergraduate medical education. For sustainability, game-based assessments should be built around clear concept maps, tight timing, facilitator scripts, and contingency plans for pacing in large cohorts.5
Strengthening health systems and public health (HSPH) learning is essential in South Africa, where inequity and a quadruple burden of disease require graduates who can apply systems thinking in complex care environments.1 Game-based learning offers an active, scalable approach to reinforce HSPH concepts. We report a student–staff partnership to co-design a game-based assessment for fourth-year medical students.2-4
METHODS:
A partnership team (five undergraduate medical students, two interns, and an academic lead) co-designed a 25-minute, station-rotation assessment delivered to a cohort of under 300 students in a fourth-year module following clinical rotations. Games were selected and adapted through iterative prototyping and feasibility testing to ensure alignment with priority health systems and public health concepts and suitability. The final Game Day comprised four rapid, facilitator-led games with a points system: (1) Bingo using short-answer questions; (2) Jubilee, a movement-based yes/no/maybe decision game; (3) Rapid Fire, a timed team-response game using flags; and (4) Connections (a categorisation task using projected terms).
RESULTS:
The format enabled high-throughput participation, repeated retrieval practice, peer discussion, and immediate feedback on health systems and public health concepts within a constrained timeframe. Students engaged competitively and collaboratively, and facilitators could quickly identify misconceptions and address knowledge gaps. Practical adaptations (simplified rules, pacing cues, and removal of one game) were necessary to maintain fidelity to time and group-size constraints.
CONCLUSIONS:
Co-designed, low-resource, rapid-cycle games can operationalise health systems and public health teaching at scale in undergraduate medical education. For sustainability, game-based assessments should be built around clear concept maps, tight timing, facilitator scripts, and contingency plans for pacing in large cohorts.5
| eISSN: | 2654-1459 |
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