With the challenges presented by the COVID-19 pandemic and constant technological advancement, the search for increasingly innovative teaching strategies has led to promoting better learning and knowledge retention. One of the strategies that has increased is Game-Based Learning (GBL). This strategy seeks to promote active learning in students using games that allow the application of knowledge in situations that reinforce or apply knowledge. GBL has been widely used in various teaching areas such as mathematics, history, engineering, etc. In recent years, the use of GBL has increased in health education. It has been used in areas such as nursing, psychology, and medicine, where it has proven to be a highly effective teaching tool. Game-based applications are widely used as educational tools. An example is the mobile game Plague Inc., which allows you to control the development of a pandemic or the search for a cure for a growing pandemic. This mobile game could be used for teaching epidemiology and medical microbiology courses. Ours medical microbiology course is taught in 5 weeks, and the amount of information taught is overwhelming. Hence, the search for didactic tools is essential to reinforce knowledge for a brief time.

The objective of this work was to implement the use of mobile games (Plague Inc., Ndemic Creations, UK) and online games (Solve The Outbreak, Centers for Disease Control and Prevention (CDC), USA) in the medical microbiology course as a tool to reinforce the theoretical content of the epidemiological chain, vaccines and pathogenesis of microorganisms. This work was conducted in April 2024 on a medical microbiology course in two groups over 5 weeks. During this period, they were asked to perform a total of 3 play-based activities. The first was to play the CDC's free game "Solve the Outbreak", which seeks to explain the basis of epidemiological surveillance. Subsequently, they were asked to carry out two activities based on the mobile game "Plague Inc." where they played in the "epidemic" mode, which sought to reinforce knowledge about virulence factors and dissemination of pathogens; and in the "find the cure" mode, which sought to reinforce knowledge about epidemiological surveillance and the importance of vaccines as a preventive tool. For each activity, an assessment was given to assess the beneficial impact the activity and reinforce prior knowledge. At the end of the course, the final exam grades and the game activities were analyzed. The MUSIC® questionnaire was used for the motivation analysis.

A similar performance was seen in the exam score in the analyzed groups concerning those where these activities were not used. However, a better performance in the exam was seen in group 2, where better scores were obtained in the game activities. On the results of the MUSIC® survey, the students expressed that the activities were useful and interesting, and more than 80% said they believed they were successful during and at the end of the course. Interestingly, group 2, which performed best in the GBL activities, showed greater interest, usefulness, and success in the course than group 1. GBL is a great didactic tool that allows the reinforcement and learning of theoretical knowledge from a fun perspective. The group that enjoyed the activities the most was the one that showed a better performance in the exam, showing a positive effect of this type of activity on the reinforcement of learning during the course.

Keywords: Higher education, educational innovation, active learning.