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 Table of Contents  
Year : 2015  |  Volume : 3  |  Issue : 1  |  Page : 127-130

Introducing innovative crossword puzzles in undergraduate physiology teaching- learning process

1 Professor and Head of Department of Physiology, Dy Director of Centre for Health Professional Education (HPE), Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India
2 Department of Physiology, Yenepoya Medical College, Deralakatte, Mangalore, Karnataka, India

Date of Web Publication13-Apr-2015

Correspondence Address:
Dr. Shobith Bangera
Department of Physiology, Yenepoya Medical College, Deralakatte, Mangalore - 575018, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2321-4848.154964

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Background: Games in physiology form an interesting avenue for teaching - learning process as it evokes interest, motivates students and is a welcome change in the monotonous routine lecture. Objective: To assess the usefulness of using crossword puzzles as a method of teaching and learning physiology among medical students. Materials and Methods: A simple crossword with clues given "across" and "down" was made using the puzzle maker website. Students were given instruction on the game rules and divided into teams. The students enjoyed the 2-hour game module and feedback from students was taken on the conduction of the crossword game and the interest generated. Results: Most of the students agreed that the game was conducted well and it was an extremely useful, fun filled, focused and an innovative change introduced by the department of Physiology. All of them gave written feedback and said they wanted more of such games. Conclusion: Using innovative interesting methods in teaching and learning programs is useful in creating interest among the students towards studying.

Keywords: Crosswords, innovative learning, physiology

How to cite this article:
Kumar LR, Bangera S, Thalenjeri P. Introducing innovative crossword puzzles in undergraduate physiology teaching- learning process. Arch Med Health Sci 2015;3:127-30

How to cite this URL:
Kumar LR, Bangera S, Thalenjeri P. Introducing innovative crossword puzzles in undergraduate physiology teaching- learning process. Arch Med Health Sci [serial online] 2015 [cited 2023 Feb 7];3:127-30. Available from: https://www.amhsjournal.org/text.asp?2015/3/1/127/154964

  Introduction Top

Undergraduate Physiology almost always involves didactic lectures which students consider boring. Moreover passive learning takes place in lectures and the retention [1],[2] rate is only 10%. Medical educators are always looking forward to develop innovative and creative educational materials that improve and complement the traditional lecture design. These innovations must aid active learning, enhance problem solving skills and promote small group discussion.

Crossword puzzle games in physiology are fun in between lectures. The crossword games may not totally replace the traditional methods of obtaining knowledge, but help in strengthening knowledge acquirement and enhance the procedural skills. [3]

The teachers and students add variety to the traditional lecture format by introducing crossword puzzles. Such games augment student participation, enthusiasm and attention in the subject matter and permit the teacher to be imaginative and novel. [4],[5],[6],[7] Games also challenge students to apply the information, thus allowing them to evaluate their critical thinking skills. [8] The crossword games create a demanding, constructively competitive ambiance that assists communication among students in a friendly and fun-filled environment.

The aim of this study was to generate supplemental materials in haematology and general physiology that would complement and enhance the information presented in the traditional lecture. The crossword puzzle was thus developed for the first-year medical students. The game-related educational materials are easy to develop and can generate interest in student teaching - learning and can also be adapted to any curriculum. These crossword games provide a unique opportunity to integrate and analyze basic concepts of physiology.


To assess the usefulness of using crossword puzzles as a method of teaching and learning physiology among medical students.

  Materials and Methods Top

Ethical clearance was obtained from Centre for Ethics, Yenepoya University.

The crossword game puzzle was conducted 1 week before the first formative assessment/ internal assessment by the department of Physiology for the first year medical students. Discussions were held by the authors and brainstorming done to select the questions. An innovative crossword puzzle was created by second author. Thirty questions and answers were constructed in crossword game puzzle in haematology and general physiology.

The crosswords were created using an online crossword maker at www.puzzle-maker.com [9]

Then crossword maker was fed with the questions constructed. Questions and answer (called as clue) were typed in the box given. On completion the crossword puzzle was created with boxes.

Implementation of the game

Pre-test and post-test were constructed on usefulness of this innovative crossword puzzle.

The crossword puzzle was conducted in lecture hall. The first and second author acted as the quiz masters. Two student volunteers were utilised to score the marks on the blackboard and also to act as timekeeper. Pre-test questionnaire were distributed. The students completed the pre-test questionnaire.

A sample crossword puzzle was shown as an example for the students. Total number of participants was 124. They were divided into 10 teams of 12 members each. The team were named as Team 1, Team 2… Team 10. The required number of prints of the empty crossword puzzle boxes were taken and distributed to the students. The quizmasters announced the rules of the game. The crossword grid was focused using PowerPoint presentation and questions were read out to the students. The crossword question was read out two times. Each crossword question was given 2 minutes to discuss and answer. The answer included saying the correct spelling. If the student answered correct, the team is required to spell the answer correctly. The correct answer was immediately filled out by the second author using the option of "Pen" in the PowerPoint. Thus the grid was getting filled up progressively with each question. The correct answer won 10 points and in the event of a wrong answer the questions went to the next team. A question which thus passes won 5 points if correctly answered. After the end of the game the post-test questions were distributed for being duly filled.

  Results Top

As depicted in [Figure 1], 42% have played crossword puzzles in news paper and 58% had not been exposed to crossword games before.
Figure 1: Depicts the number of students who have previously played crossword puzzles: Yes: 42% and No 58%

Click here to view

As depicted in [Figure 2], there was significant difference in pre- and post-test scores (P < 0.05) and the students reported that crossword game puzzle in physiology was interesting, fun-filled, innovative, creative, promotes small group discussion within their teams and promotes active learning.
Figure 2: Depicts the pre and post-scores of the students before and after the crossword puzzle in physiology (P < 0.05%)

Click here to view

The comments and advantages: Given in addition by the students were: Crossword puzzles: "was a relief after monotonous lectures'; " interactive"; " fun to learn physiology in this puzzle and guess the correct spellings" ; " helped to consolidate knowledge".

The disadvantages given by the students were: "sometimes two answers were possible"; "some teams were better prepared"; "students need a collar mike to speak out the answer".

All students agreed (100%) that they wanted more such games in future.

  Discussion Top

All the students gave feedback that they wanted more such games in the other systems in physiology.

Crossword puzzles and educational games are becoming an increasingly popular tool that many educators use to encourage student involvement with the lecture material. Students are challenged to engage in active learning, problem solving, and small group discussions in a non-threatening environment through the use of games. The students consider lectures as monotonous and passive transfer of knowledge. The crossword puzzle lightens the teaching environment and makes learning fun and active. Many disciplines use games within their curriculum. For example, crossword puzzles are reported to be an effective way for nurses to review standard procedures, integrate physiological systems and maintain knowledge required for everyday care of patients. [1],[8],[10],[11]

The crossword puzzles provide students a unique, innovative and fun opportunity to evaluate their own level of learning by identifying concepts that have not been mastered. [5],[6],[7] The student's inability to answer a question helps to identify areas of concern or weakness that can be corrected by targeted studying.

The crossword puzzles promote an opportunity for students to use critical thinking and problem-solving skills. It encourages the students to be creative and innovative.

Medical educators look for materials that balance and augment lecture material without compromising class time. These supplemental materials do not require the instructor to remain in the classroom, and no additional class time is required. The game allows the student to review information in a new, exciting, fun and challenging format.

  Limitations Top

In the puzzle one of the answers was "Myasthenia Gravis" But it was discovered that only one word could be used as answers.

During conduction it was revealed that sometimes students did not know the spelling. Thus a rule was added that the spellings needs to be told specifically in order to score the points.

Pre and post-test questions

Please read the question and choose your options according to: 1. Strongly disagree, 2. Disagree, 3. Neither agree nor disagree, 4. Agree, 5. Strongly agree.

  1. Have you taken part in crossword puzzles during learning? Yes / no.
  2. Do you think crossword games in physiology would be interesting? 1, 2, 3, 4, 5.
  3. Would crossword games be a fun educational tool? 1, 2, 3, 4, 5.
  4. Do you agree that crossword games are innovative and creative? 1, 2, 3, 4, 5.
  5. Would crossword games enhance problem solving skills? 1, 2, 3, 4, 5.
  6. Do you agree that crossword games would encourage small group discussions? 1, 2, 3, 4, 5.
  7. Do you agree that crossword games in physiology promote active learning? 1, 2, 3, 4, 5.
  8. List any two advantages in the crossword puzzle game you experienced.
  9. List any two disadvantages in the crossword puzzle game you experienced.
  10. Would you like to have more crossword puzzles in physiology? Yes/ No.
Cross word Puzzle and Grid Constructed and answers:


2. Used to measure ECF.

4. Process of clotting is example for ________ feedback.

9. Suicidal Bags.

12. Type of intercellular communication via circulating blood.

15. Electrically insulating material that forms a layer around axon of a neuron.

16. Autoimmune muscle disease.

17. Antigen-antibody reaction.

20. Coarse brick red granules.

21. Defense.

22. Equation used for determining equilibrium potential.

24. Skeletal muscle fibre arrangement.

25. Reduction in membrane potential from negative value towards zero.

26. Iron containing Porphyrin.

27. Carrier-mediated diffusion.

28. Make cell tasty.

29. Immature large RBC.


1. Factor IV.

3. In vivo Anticoagulant.

4. Cell-eating Cell.

5. Subcutaneous haemorrhagic spots.

6. Type of contraction with no change in muscle length.

7. Metal required for production of haem.

8. Thick filament, contractile protein.

10. Destruction of RBC.

11. Destroys acetyl choline.

13. B-Cell-mediated immunity.

14. Cell migration across endothelium.

18. Non-propagating potential.

19. Yellow pigment.

  References Top

Blouin RA, Joyner PU, Pollack GM. Preparing for a renaissance in pharmacy education: The need, opportunity, and capacity for change. Am J Pharm Educ 2008;72:42.  Back to cited text no. 1
Blouin RA, Riffee WH, Robinson ET, Beck DE, Green C, Joyner PU, et al. Roles of innovation in education delivery. Am J Pharm Educ 2009;73:154.   Back to cited text no. 2
Bartley PD. Crossword puzzles. J Emerg Nurs 1997;23:64-7.  Back to cited text no. 3
Kuhn MA. Gaming: A technique that adds spice to learning? J Contin Educ Nurs 1995;26:35-9.  Back to cited text no. 4
Lewis DJ, Saydak SJ, Mierzwa IP, Robinson JA. Gaming: A teaching strategy for adult learners. J Contin Educ Nurs 1989;20:80-4.  Back to cited text no. 5
Nagy LM, Spencer A, Boettler C, Rogers A, Panella K. Crossword: Universal precautions. J Contin Educ Nurs 1993;24:238-9.  Back to cited text no. 6
Penrod HC, Bays CL. Drawing to learn and win. J Nurs Educ 1991;30:140-1.  Back to cited text no. 7
Rowell S, Spielvogle S. Wanted: "A few good bug detectives". A gaming technique to increase staff awareness of current infection control practices. J Contin Educ Nurs 1996; 27:274-8.  Back to cited text no. 8
Watman MX. The New Puzzle Factory. [Online] Software Labs, Inc. Available from: http://www.softwarelabs.com/games/games619.htm [Last accessed on 1998 Jan 20].  Back to cited text no. 9
Speers AT. Crossword puzzles: A teaching strategy for critical care nursing. Dimens Crit Care Nurs 1993;12:52-5.  Back to cited text no. 10
Talavinia-Pasek T. Pediatric/neonatal critical care respiratory crossword puzzle. MCN Am J Matern Child Nurs 1995; 20:46-7, 55.  Back to cited text no. 11


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