We recently developed an educational game for reviewing respiratory physiology in a large classroom. The "Who Wants to be a Physician?" game encouraged medical students to be active participants in the learning process. An evaluation of the game documented that students enjoyed the active format, and the students reported that the game enhanced their ability to understand and retain information. However, the evaluation also revealed that the game had limitations. Specifically, the students recommended the use of multiple-choice questions to match the Medical Board Examination format and to speed up the game (i.e., cover more topics). The students also wanted to increase their level of participation and interaction. Finally, we wanted to emphasize the benefits of peer instruction as a collaborative learning tool. To address these limitations, we designed a new game, "Survivor." Survivor incorporated multiple-choice questions and emphasized peer instruction and a capacity to gather information and solve novel problems. In addition, participation was increased by including the student audience in the game. Finally, an evaluation instrument was utilized to assess the effectiveness of this instructional tool in an academic setting. As a result of these improvements, the evaluation documents that the newly developed tool is a more effective educational game that couples fun and creative excitement with proven and effective educational concepts.

Key words: educational tool; collaborative learning; education; pulmonary physiology