Table 1.

Gamification component by Bedwell game attributes category and based on Landers theory of gamified learning

Game attributes	Gamification elements
Action Language	The student played the game as a single user on the computer or smart phone online, using the computer keyboard or mouse or touching the phone screen and typing.
Assessment	For all activities, instant feedback of correctness or incorrectness, explanation of wrong options, earning or deducting points, points of each level, total points, scoreboard and flag of the successful passage of the level or challenge were provided. Moving from each level to the next level depended on taking the minimum target score set at each level.
Conflict/Challenge	According to the learning objectives, the content was designed in 5 levels with increasing difficulty. The student answers questions with different Bloom's taxonomy, including knowledge, understanding, application, and analysis. In the levels of the first to third, the feedback includes whether the answer is correct or incorrect, an explanation of the correct answer and the reasons for rejecting the other options (this feedback is displayed if the wrong option is selected). In the fourth level and final challenge, the feedback only includes whether the answer is correct or incorrect. In the last challenge, the wrong answer was accompanied by a deduction of points.
Control	The player chooses an avatar as the narrator. At the end of each level, the player can replay that level and gets a higher score or go to the next level. Also, if the player receives the desired score, the player will skip the final challenge at own discretion.
Environment	The game environment was designed two-dimensionally with the experience of the health major student’s life reality to remember what was learned and help others solve the problem.
Game fiction	In the game, the student is looking for help to solve the question of two young health employees. For this purpose, the player goes through the stages of recalling the knowledge and concepts of hypothesis testing and conducting some examples of hypothesis testing. In the fourth level, the player solves the relevant employees’ question. Lastly, the student deals with the challenge of skill and mastery in conducting hypothesis testing. The game occurs in various collegian backgrounds, including a coffee shop, library, tablet or pen and paper on a table.
Human interaction	The interaction of students with each other and the instructor was planned through the class WhatsApp group outside the game so that students could share their progress, ask questions and receive relevant guidance.
Immersion	Computer or smart phone interfaces were considered for playing to facilitate the immersion. Touch, drag and drop and typing were used to play the game. Feedback in the form of the avatar face or a failure or success voice was provided. At the first level, pseudo competition between the player and avatar, using a designed algorithm, was an attempt to involve the player emotionally and believability of the game characters. In various cases, clues (such as images for the formulas guide) were used to keep the player engaged with the game and overcome the challenges. To create a sense of security and avoid failure, each stage of the game could play again.
Rules/Goals	The game’s general purpose and how to play it were explained upon entering the game. In an overview, the path of the game and the topic of each level were displayed for the player. The player should answer all the questions at each level. To pass each level and unlock the next level, the player should earn a specific score informed at the beginning of each level.