Background:Modern learners find classic didactic lectures ineffective1and favour more interactive teaching modalities2. In response to requests for more active learning sessions, we incorporated flipped classroom (FCR) activities with quiz games into subject reviews. Here we present continuing data from undergraduate students (Ug) and between 1styr (M1) and 2ndyr medical students (M2). The data allows us to examine whether the incorporation of gaming into the student’s learning has continued to have a beneficial effect. Activity:We described previously where FCR sessions for Ug, M1 and M2 students, were augmented with a review activity conducted using gaming and students surveyed about the usefulness of the gaming activity. In this study, we added two further quiz gaming formats to the FCR review sessions and compared the effectiveness of using polleverywhereÔ(PEW) and KahootÔ(KT) for Ug students, and for previous M1 students who had progressed to M2 level, we compared the effectiveness of using PEW and Double JeopardyÔ(DJ) formats. Results:Preferred modality for Ug students- A comparison of PEW (n= 31) and KT (n= 32) modalities, showed that both were very effective in delivering review content and making the students feel engaged. A Mann-Whitney test indicated that KT (MedianKT= 4.5) was preferable to PEW (MedianPEW= 4.0), by students for delivery of materials, U= 226, p< 0.01. A similar preference was observed for the students’ engagement (MedianKT= 5.0, MedianPEW= 4.0; U= 175, p< 0.01). Does preference change over time- A comparison of student responses M1 (n= 28) and M2 (n = 47) showed that the level of effectiveness and engagement remained high and that there was no significant difference between the M1 and M2 years using PEW to deliver content reviews (MedianM1-PEW = MedianM2-PEW = 4.0, U = 604.5, p = 0.531). The findings suggest that DJ was very effective for engagement in M2 class review sessions, and while there was no significant difference in the levels of engagement between PEW (n=47) and DJ (n=19); students did show a slight preference for the DJ activity (MedianPEW = 4, MedianDJ = 5, U= 379.5, p = 0.363). Discussion: The results show that students find the inclusion of gaming activities very effective both for reviews and engagement level and that the level of effectiveness does not diminish between years. The introduction of different modalities throughout the course, was also well received. However, KT has limited use, as there are character limits for questions and answer options, however Ug students viewed it as great fun. Additional student comments included: more time to read questions; harder questions; more discussion of answers; slower pace. Conclusion: Students continue to find the use of gaming to be very engaging and effective in reviewing course materials and that using different modality can be effectively used without loss of perceived benefits.