The goal of this clinical trial study is to evaluate the effectiveness of a board game-based serious game as a learning strategy to improve knowledge and study motivation on antibiotics and bacteria topics in undergraduate dental students at Faculty of Dentistry, Universitas Indonesia.

The main questions it aims to answer are:

• Does the "D'Antibiotika Academy" board game lead to higher post-test scores compared to traditional handout-based learning?
• Does the board game improve students' study motivation on antibiotics and bacteria topic?

Researchers will compare the board game intervention group to the traditional handout (control) group to see if the game-based approach provides superior learning outcomes and higher student engagement.

Participants will:

• Complete a pre-test to measure their baseline knowledge of bacteria and antibiotics.
• Participate in a learning session using either the "D'Antibiotika Academy" board game or a conventional handout.
• Complete a post-test 1 and post-test 2 immediately after the session to measure immediate knowledge gain.
• Switch groups (crossover) after a washout period to ensure all participants experience both methods.
• Complete a study motivation questionnaire after the completion of the sessions.

Study Design and Setting:

This study was a single-blind crossover randomized controlled trial conducted at Universitas Indonesia from September to December 2025. The participants (n=101) were undergraduate dental students from the Faculty of Dentistry, Universitas Indonesia. Participants were stratified by academic year and then assigned to either the HO-BG (Handout then Board Game) or BG-HO (Board Game then Handout) group using stratified random sampling. Ethical approval was secured from the Dental Research Ethics Committee, Universitas Indonesia (54/Ethical Approval/FKGUI.IX/2025).

Interventions:

The study compared two learning media with identical content regarding antibiotic classification, mechanisms of action, resistance, selection, bacterial classification, and quorum sensing:

• Board Game (D'Antibiotika Academy): An interactive game played in groups of 4-5 students.
• Handout: A digital text-based learning material for independent study.

Study Protocol:

• Baseline: All participants completed a pre-test to establish baseline knowledge.
• Phase 1: The HO-BG group studied via handout independently, while the BG-HO group played the board game in a supervised two-hour session at the Health Sciences Cluster Building. Phase 1 concluded with Post-test 1.
• Washout Period: A one-week washout period was implemented to minimize carryover effects.
• Phase 2 (Crossover): The groups switched interventions. The HO-BG group played the board game, and the BG-HO group accessed the handout. After one week, all participants completed Post-test 2.

Assessment Tools:

• Knowledge Test: 40 shuffled multiple-choice questions (20 questions for antibiotic topic and 20 questions for bacteria topic) administered via Google Forms (Max score: 100).
• Motivation Questionnaire: At the study's conclusion, participants completed the Instructional Materials Motivational Survey (IMMS) based on the ARCS Model (Attention, Relevance, Confidence, and Satisfaction). Each participant evaluated both the board game and handout methods.

Inclusion Criteria:

• Undergraduate dental students at the Faculty of Dentistry, Universitas Indonesia, from the class of 2022, 2023, and 2025.
• Students who demonstrate a clear understanding of the study's explanation provided by the researchers and are willing to participate by signing the informed consent form.
• Students who are committed to participating in all research sessions and procedures until completion

Exclusion Criteria:

• Students who are unable to participate in the entire research sequence from beginning to end.
• Students who withdraw their participation at any point during the study period.

Individual participant data will not be shared because the dataset contains identifiable educational records of students and institutional policies restrict public data sharing.

The outcome assessor responsible for scoring knowledge tests and questionnaire results will be blinded to the intervention sequence.