Medical students often struggle with prework completion and engagement, arriving to class unprepared. Gamification uses game elements such as an overarching narrative and immediate feedback to enhance learner motivation, behavior, and attitude. Grounded in Cognitive Constructivism and Self-Determination Theory, this project examines whether gamified prework better prepares pre-clerkship students for didactic sessions than traditional prework. We used Articulate Storyline to create 3 gamified prework activities: one for 1st year students and two for 2nd year students on genetics and antibiotics, respectively. Activities included themed scenarios, interactivity, embedded resources, and immediate feedback. Data collection includes prework completion rates and student perceptions from a survey. Completion rates for the gamified prework were lower than traditional formats (Antibiotics Storyline: 32%, n=30; Dysuria Storyline: 40%, n=38; traditional quiz: 67%, n=64); (Genetics Storyline: 51%, n=53; traditional quiz: 61%, n=64). However, among 83 first-year student respondents, 65% agreed/strongly agreed that gamified prework better prepared them, compared with 7% and 28% who disagreed/strongly disagreed and were neutral, respectively. Among 79 second-year students, 49% agreed/strongly agreed compared with 23% who disagreed/strongly disagreed and 28% who were neutral. Students described the gamified prework as engaging, and effective for content retention, active learning, and knowledge gap identification. Reported challenges included excessive length, technicalities, difficulty misalignment, and limited reviewability. Students perceived gamified prework as potentially effective, but its impact on completion and preparation was mixed. Results suggest optimizing length, technicalities, difficulty alignment, and integration with study habits. Future work will address these factors and assess knowledge gains.