Purpose
Gamification can enhance student engagement and application of knowledge, especially in the foundational sciences. This study aims to determine if a daily quiz game increases student engagement and academic performance in a first-year medical curriculum.

Methods
A Question-of-the-Day game was created to accompany a foundational science course for first-year medical students. Participants received daily multiple-choice questions linking current and past content. The game, programmed in the Brightspace/D2L LMS, sent daily reminders, awarded points for regular participation, displayed detailed answer feedback and showed a participant leaderboard. Course grades and learner engagement of case-matched participants and non-participants were compared using non-parametric statistics, and participants were invited to share their impressions of the game with an anonymous survey.

Results
Game participation correlated only minimally with a change in course grades or engagement (correlation coefficients of 0.04 and 0.1, respectively). Compared to matched controls, students who completed >50% of daily quizzes had only marginally better grade trends and engagement over the course of the game (p=0.325 and 0.061, respectively). Survey responses show that participants felt that the game improved their engagement with the course but were less positive about the impact that participation had on their grade.

Conclusion
Participants saw the Question-of-the-Day game as an effective and fun activity that improves engagement with course content. However, game participation had no significant actual effects on grades or engagement with online materials. Since these effects were not detrimental and student feedback was positive, it is concluded that such games make a worthwhile addition to online study materials even though their impact on learning might be negligible.