Abstract
Background: Even though many recent innovations are done in various teaching-learning methods adopted, the undergraduate bulk of teaching is still delivered through didactic lectures in most of the medical schools. Most of the students find these didactic lectures very boring and also many researches have shown that lectures, a passive method of learning, provide the lowest retention rate of knowledge in comparison to active methods of learning that involves discussing in groups, tutorials, and teaching to others are much more effective. Hence, games like crossword puzzles can be used to teach undergraduates in learning the key concepts in physiology as it can induce interest among students and can also be used as a tool to assess the enhancement in learning after the lectures, this can be a welcome change in the monotonous routine lectures.

Aims and Objectives: The objectives of this study were as follows: (i) To administer crossword puzzle before and after lecture, (ii) to evaluate the enhancement of learning after lecture, (iii) to obtain feedback on usefulness of crossword puzzle in effective learning, and (iv) to analyze the change in the performance in relation to feedback.

Materials and Methods: The study was conducted on 150 1st year MBBS students after obtaining Ethical Clearance from the Institutional Ethical Committee, Adichunchanagiri Institute of Medical Sciences. Simple crossword on endocrine physiology was constructed with clues given “across” and “down” using the crossword puzzle maker website. Before the start of lecture on “Introduction to Endocrine Physiology,” students were given instruction on the rules of the games and were divided into teams, each team consisting of six students according to their roll number, the crossword puzzle was given to different teams, time allotted was 8 min. Later, 1-h lecture on the topic was delivered and same crossword puzzle was given to solve after the lecture to assess the enhancement of learning after lecture and feedback was obtained on usefulness of crossword puzzle in effective learning.

Results: Pre-test score of the students of crossword puzzle before the start of the lecture was 4.76± 1.09 and the post-test score of the students after the lecture was 11.72 ± 1.6 (P < 0.1); this was highly significant. Feedback obtained from the students was indicative of that they want more such games in physiology which they felt it interesting, innovative, creative, and fun educational tool and helped them in understanding new words as well as concepts in physiology.

Conclusion: Hence, from the present study, we conclude that games like crossword puzzles can enhance learning among students as indicated by post-test score. Most of the students strongly agreed that discussing in groups could increase their understanding of the topic better as well the competitive aspect of doing the puzzle contributed to their effectiveness.

Key words: Crossword Puzzle; Teaching-Learning Methods; Enhancement; Physiology