Discussion
The present study was conducted to evaluate new learning strategies for interactive learning environments with asynchronous settings in dental education, in particular, the study of oral histology. The results of this study showed The main consideration for combining games with education is the ability of games to provide high motivation and potentially make the learning process easier, especially for the learning subjects that students perceive as less interesting. Serious games are different from traditional learning and are considered to provide a more interactive learning environment, support increased motivation, and safe training for students [The application of challenges in serious games can make learning activities more interesting and motivate students to complete the games. However, there must be a balance between the challenge and the student’s ability. If the challenge is too difficult to complete, the students could lose motivation to complete the game [The present study highlights the importance of introducing an innovative learning approach to enhance knowledge acquisition and improve the overall learning environment. However, this study had some limitations. The first limitation of the study was the relatively low response rate of 53.6% of total first year dental students, although students were strongly encouraged to take part in this study, their participation remained voluntary. The number of non-respondents might undermine the power of the study and therefore the potential response bias can not be completely ruled out. The results of the study must be interpreted with caution. Second, the generalizability of the results of the present study was limited by the use of data from a single university with a discrete population of first year dental students. As each dental school may have different conditions that influence the use of serious games in their curriculum [