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Serious educational gameplay (SEG) continues to gain traction in K-12 educational settings as access to novel technologies increases. Serious games may have particular utility in elementary science classrooms, where teachers are trained as generalists. This study stems from a larger project that created a SEG, Virtual Vet, designed to teach the human body systems through immersive gameplay. Students (n=177) completed multiple content and attitude assessments that confirmed significant learning gains. This convergent mixed methods study was designed to deeply explore how and when learning takes place during gameplay through analysis of 150 assessment items embedded within gameplay. The game design heuristics were analyzed to collectively identify particular in-game scaffolds, feedback mechanisms, and visualizations that support elementary science learning.