PURPOSE
At WMed, an asynchronous “choose your own adventure” game was developed
based on the Hallmarks of Cancer framework. Students attempt to earn all 8
hallmarks by selecting genetic modifications to overcome obstacles and then
answering practice questions related to the associated hallmark. At ZSOM, a
small group session called the BIG Picture of Cancer (BPC) provides an
opportunity for students to review and apply molecular biology material to
the Hallmarks of Cancer. We merged these, using the game as prework to review
learned material and prepare for the BPC session. The game’s value to
students was assessed using a post-event survey and game tracking data.
 
METHODS
The game was introduced in 2023 at WMed. In November 2025, the game was
modified to fit the ZSOM curriculum and then introduced as prework for the
BPC session. Students were invited to complete a post-event survey to
evaluate 1) student-reported confidence and knowledge of cancer biology
topics, 2) perceptions of the game’s effectiveness and enjoyment and 3) the
utility of the game as prework for the BPC session. The paths taken through
the game and when it was accessed were also tracked.
 
RESULTS
Students at ZSOM accessed the game 82 times during the week it was
assigned. 71 (86.6%) were winning attempts while 11 attempts ended when
students quit the game. Tracking is still underway to determine if students
return to the game as a study tool during Summative Exam week. Survey
analysis is currently ongoing, but students have indicated informally that
they found the game useful to apply molecular biology content.
 
CONCLUSIONS
The “Hallmarks of Cancer” game was readily modified to fit the ZSOM
curriculum. The majority of students utilized it prior to the BPC session,
and overall, the game has been well-received by students at ZSOM.