# Choose Your Own Adventure: Using Twine for Gamified Interactive Learning in Veterinary Anaesthesia

## TL;DR

A web-based Twine system gamifies veterinary anaesthesia training, showing high student satisfaction and effectiveness in improving knowledge and decision-making.

## Contribution

The novel use of Twine for gamified, web-based veterinary anaesthesia training with clinical scenarios and its positive impact on learning outcomes.

## Key findings

- 90.8% of students found the Twine system effective for training in veterinary anaesthesia.
- 97% of participants agreed the system improved their knowledge of anaesthesia.
- 96.7% rated the workshop as 'good' or 'excellent', highlighting its user-friendliness and engagement.

## Abstract

Veterinary anaesthesia requires theoretical knowledge and quick decision-making skills, but traditional methods often fall short in realistic training. To address this, we developed a web-based interactive learning system using Twine, featuring five clinical cases that simulate real-world anaesthesia scenarios with gamified elements like scoring and resource management. After a workshop for veterinary students, we surveyed 367 participants, of whom 90.8% found the system effective, and 97% agreed it enhanced their knowledge. The platform was deemed user-friendly, with 96.7% rating the workshop as “good” or “excellent”. Suggestions for improved mobile compatibility and additional resources were noted. Twine’s interactive approach reduces reliance on live animals and is globally accessible via web browsers. Future studies will assess its impact on skill retention and adaptability in various learning environments, providing a modern solution for veterinary education.

Veterinary anaesthesia requires theoretical knowledge and quick decision-making skills. Traditional education may not adequately prepare students, while simulation-based learning enhances engagement and skill development. This study evaluates the effectiveness of a Twine-based web system in improving experiential learning, engagement, knowledge retention, and decision-making skills in veterinary anaesthesia students. Five interactive clinical cases were developed using Twine, simulating realistic anaesthesia scenarios with decision points and gamified elements, such as scoring systems and resource management. These modules were accessible on various devices via the web. Following a workshop for second- to fourth-year students of the Degree in Veterinary Sciences, an anonymous survey assessed the module’s effectiveness. Quantitative data were analysed descriptively, while qualitative feedback was processed through a hybrid AI–human thematic analysis. Out of 849 invited students, 367 responded (42% response rate). Feedback was highly positive; 90.8% found it effective for training, and 97.0% agreed it improved knowledge. User-friendliness was rated as “easy” or “very easy” by 94.6%. Regarding overall satisfaction, 96.7% of students described the workshop as “good” or “excellent”. Some participants suggested improvements in mobile device compatibility and the need for additional resources to understand the concepts better. Twine’s interactive format fosters experiential learning while reducing reliance on live animals, aligning with modern ethical standards. Its accessibility via web and translation-enabled browsers enhances its reach. Future research should examine Twine’s impact on clinical skills retention and adaptability in various educational contexts, providing a flexible approach to veterinary anaesthesia education through gamified learning.