Board and card games in medical education
Table of contents
A second-year class, split into tables of four. At each table, a printed board, a deck of cards with pharmacology questions and plenty of discussion about who got it right first. The teacher moves between the tables, listens to the reasoning and corrects a thinking error before it spreads. Nobody looks at a phone for fifty minutes.
NEXO is a daily medical diagnosis game: one clinical case a day, six progressive clues, and ICD-10 proximity feedback across five levels.
Board and card games entered medical education through the creativity of teachers and students. They are cheap, fit in any room and encourage conversation among colleagues. This guide shows what the studies say about these games, why they can work, what their limits are and how to choose, adapt or create one for your class, league or study group.
Key points
- Studies with board and card games in Medicine show knowledge gains and good acceptance.
- Almost all are small studies, from a single institution and with assessment right after the game.
- Health professionals prefer short, simple games for two to four players.
- Content accuracy is one of the main concerns of those who use these games.
- Tabletop simulations with a board are also used to train teams in emergencies.
Why physical games
Conversation around the table
A physical game brings people together in the same place and forces them to talk. When a player answers a card, the others check, challenge and explain. This back and forth resembles peer teaching, in which each student has to justify their own reasoning out loud.
Easy to produce
Compared with digital games, board and card games require little: paper, a printer, a few pieces and good questions. A review of the design of these games notes that they are relatively easy to develop, grounded in educational theory and generally well accepted by students, and yet they are rarely described in the medical education literature (Cosimini and Collins, 2023).
Repetition with a purpose
Answering the same questions over several rounds is a form of retrieval practice. The game gives a reason to repeat: win the round, help the team, reach the end of the board. Repetition stops feeling like review and starts feeling like a match.
Most common types
- Question track: the team moves forward on the board with each correct answer.
- Association cards: match cards of mechanism, finding and management that go together.
- Narrative: a story in stages, with decisions that change the path.
- Tabletop simulation: teams discuss a situation on a map or board, with pieces for resources and people.
What the studies show
Board with question cards
In a study with 102 second-year students, a 50-minute session with a board and question cards on the diagnosis and management of a common chronic disease raised the mean knowledge score from 7.3 to 8.0 on a 10-point scale (Twist and Ragsdale, 2022). Students' confidence in the topic also increased, and satisfaction was very positive (Twist and Ragsdale, 2022).
Cards against lectures
In a randomized trial with 48 students, one group learned neurological syndromes with a card game of association and lesion localization, and the other had lectures with slides and case analysis (Yu et al., 2025). The game group performed better on assessments made one, three and six weeks later, as well as better content retention at all these points (Yu et al., 2025). The game students also reported lower cognitive load and more interest in the topic (Yu et al., 2025).
Narrative, cards and board together
A game that combined story, cards and board to teach acid-base balance to first-year students recorded an increase in the mean test score from 7.57 to 16.14 points, as well as more confidence and very positive feedback (Surapaneni, 2024).
Immunology on a board
In a study with 41 first- and second-year students, an immunology board game led to an average improvement of 27% on the test among those who had not yet taken the course and of 19% among those who were taking it (Mckee et al., 2025). Fun was rated highly, with an average of 4.59 on a scale of 5, but students found the rules hard to understand (Mckee et al., 2025).
Teams in emergencies
A scoping review of tabletop simulations in medical emergencies included 70 studies, and 37% of them used a board (Frégeau et al., 2025). Most dealt with disaster situations, in 80% of the studies, and involved participants from several professions, in 64% (Frégeau et al., 2025). Almost all reported positive results in satisfaction and learning, and few measured behavior change in practice (Frégeau et al., 2025).
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Limits of the evidence
Small, short-term studies
Most studies have a few dozen participants, take place at a single college and measure knowledge right after the game. Long-term retention and impact on clinical practice are almost never assessed. In addition, those who create the game are often the ones who evaluate it, which tends to favor positive results.
Compared with what?
Many studies compare the same group before and after, without a control group. In these cases, part of the gain would come from any review of the content. Studies with a comparison, such as the one on cards versus a lecture, are more informative, but still rare.
The content has to be right
A fun game with wrong information teaches the error more strongly, because the answer becomes a memory of a match. In a survey with 335 health professionals who downloaded a card game about antibiotics, concern about content accuracy was among the most cited barriers, alongside the lack of games on the desired topics and the cost (Cosimini and Collins, 2023).
Complicated rules get in the way
When the rules take up class time, learning suffers. The immunology game was rated highly, but the rules were the main complaint (Mckee et al., 2025).
How to choose or create a game
Start with the goal
Define what players should know or be able to do at the end of the match. A game to memorize mechanisms of action is very different from a game to practice the order of decisions in an emergency. The goal decides the type of game, not the other way around.
Short and simple
The same survey with 335 professionals showed a preference for shorter, less complex games, with two to four players (Cosimini and Collins, 2023). The authors recommend that educators start with games like these (Cosimini and Collins, 2023). A game that fits in 20 to 30 minutes leaves time to discuss the answers, which is where much of the learning happens.
Review the content
Ask a professor or specialist to review each card before using the game. State the source of each answer. Update the cards when the guidelines change.
Think about accessibility
Use large letters, colors with good contrast and symbols in addition to color, so that students with color blindness can play. Prefer cards that everyone at the table can read and rules that fit on one sheet. A game that excludes part of the class loses the main benefit of board games, which is getting everyone talking.
Test with a few players
Play one match with two or three colleagues before bringing it to the class. Watch where people get confused by the rules, which cards are too easy and which ones spark good discussion. Adjust and test again.
Balance between luck and knowledge
Dice and drawn cards add excitement, but if luck weighs too much, those who studied lose to those who rolled the right number. Make knowledge decide most of the moves. Care with rewards that keep the player engaged without teaching is the subject of another guide in this series.
How to use it in class or in a group
Before the match
Explain the goal of the activity and the rules in a few minutes. Form small groups and mix students with different levels of knowledge.
During
Walk among the tables, listen to the reasoning and correct mistakes on the spot. Encourage players to explain why an answer is right, not just to say which one it is.
Afterwards
Set aside time to discuss the hardest questions with the whole class. This closing turns scattered points into organized reasoning. If possible, ask a few questions weeks later to check what stuck.
Adapt to the time available
Some classes fit only part of a game. In 15 minutes, a deck of association cards works as a warm-up at the start of class or as a closing at the end. In an hour, there is room for a trail game with discussion. In a whole morning, a tabletop simulation lets teams make decisions in sequence and see the consequences. Choose the format by the time you have, not the other way around, and agree with the class on when the game will end.
In leagues and study groups
Card games work well as a quick review before exams and as an activity that brings classes together. Creating your own game is also a good project for a league: writing the cards forces you to study the topic in depth.
From the board to the case of the day with NEXO
Board games bring the class together; the case of the day follows each student through the rest of the week. The NEXO case is fictional, with a real clinical presentation, and the diagnosis arrives in up to six clues, with proximity in ICD-10 showing how far each guess landed. A study group can play the case of the day and discuss each person's hypotheses at the next meeting.
The guide what NEXO is explains the whole game, and the release of modes is on the NEXO economy page.
If you coordinate a medical school, a league or a residency and want cases to use with your class, see NEXO Closer. Researchers in medical education can propose studies through NEXO Researcher. Doctors who review cases take part through NEXO Curator, and those who create health content on social media can take part through NEXO Creators.
Frequently asked questions
Do board games teach Medicine?
Small studies show knowledge gains right after the game, as in an immunology game where the average improvement reached 27% (Mckee et al., 2025).
Are they better than other activities?
In a small randomized trial, a card game beat the lecture in learning and retention up to six weeks later (Yu et al., 2025). There are still few comparisons of this kind.
What is the ideal size for a game?
Health professionals prefer short, simple games for two to four players (Cosimini and Collins, 2023).
What is the biggest risk?
Teaching wrong information. Have a specialist review the content of every card.
Are they useful for training teams?
Tabletop simulations with a board are used in emergencies and disasters, with positive results in satisfaction and learning (Frégeau et al., 2025).
Can I create my own game?
You can. Start with the objective, keep the rules simple and test with a few colleagues before using it with the class.
Checklist for playing in class
- Define the objective of the game.
- Prefer short games with simple rules.
- Review the content with a specialist.
- Test with a few players before the class.
- Balance luck and knowledge in favor of knowledge.
- Form small groups with a mix of students.
- Discuss the answers at the end of the game.
- Check retention weeks later.
Want a new clinical case to discuss with the group? Play the case of the day on NEXO.
References
- Cosimini MJ, Collins J. Card and board game design for medical education: length and complexity considerations. Korean J Med Educ. 2023. https://pubmed.ncbi.nlm.nih.gov/37670525/
- Twist KE, Ragsdale JW. Candy Gland: A Diabetes Board Game for Medical Students. MedEdPORTAL. 2022. https://pubmed.ncbi.nlm.nih.gov/36654983/
- Yu X, Wu J, Zhang Y, Di Z, Nie W, Wang M, et al. Randomized trial on the impact of card Game-Based teaching on learning and memory retention of neurological syndromes. BMC Med Educ. 2025. https://pubmed.ncbi.nlm.nih.gov/40653496/
- Surapaneni KM. "Aquilibria: The battle to balance"-a narrative card and board game on acid-base regulation for first-year medical students. Adv Physiol Educ. 2024. https://pubmed.ncbi.nlm.nih.gov/38205518/
- Mckee C, Allowitz K, Boster S, Plowman T, Stutz H, Paul A, et al. The Immunology Game: A Board Game to Enhance Medical Immunology Education. MedEdPORTAL. 2025. https://pubmed.ncbi.nlm.nih.gov/41141212/
- Frégeau A, Vinette B, Lapierre A, Maheu-Cadotte MA, Fontaine G, Castonguay V, et al. Tabletop Simulations in Medical Emergencies: A Scoping Review. Simul Healthc. 2025. https://pubmed.ncbi.nlm.nih.gov/39625695/