Shahroud University of Medical Sciences Shahroud Journal of Medical Sciences 2423-6594 12 2 2026 05 02 Medical Education with a Flavor of Play: Keys to Sustaining the Impact of Gamification on Learning 49 52 eng Ehsan Toofaninejad Department of eLearning in Medical Sciences, School of Medical Education and Learning Technologies (SMELT), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Haniye Mastour School of Medical Education and Learning Technologies (SMELT), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Kolsoum Deldar Department of Health Information Technology, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran. 2025 06 07 2025 11 02 Gamification has emerged as an innovative strategy in medical education to enhance learner engagement, motivation, and knowledge acquisition. Despite promising short-term outcomes, sustaining its long-term educational impact remains a significant challenge. This paper discusses key strategies to enhance the durability of gamification in medical training based on field experience and a targeted literature review. Critical components include delivering meaningful and immediate feedback, balancing intrinsic and extrinsic motivational drivers, integrating gamified systems into real clinical environments, and combining game-based learning with reinforcement approaches such as self-regulated learning (SRL). Additionally, continuous evaluation and optimization of gamified platforms—through personalization, dynamic challenges, and regular content updates—are emphasized as essential for maintaining learner engagement. Embedding gamification within authentic clinical workflows, including electronic health record systems and case-based simulations, may further strengthen its relevance and practical impact. Carefully designed pilot interventions incorporating adaptive learning paths, structured feedback, and real-world clinical scenarios are recommended before large-scale implementation. Future research should focus on longitudinal evaluations and the development of advanced, sustainable gamification technologies to improve long-term clinical competence among medical students. Keywords: Gamification, Medical education, Motivation, Self-regulated learning, Clinical training.