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Gamification has sparked significant interest in educational contexts. However, there is a rather low adoption rate of gamification in authentic classrooms. Attracting in-service teachers to use gamification is crucial to enhance students’ language learning experiences. However, few studies have examined teachers’ perceptions of their uptake and sustainable use of gamification. This case study analyzed the co-design process of different types of gamified language learning activities among four Hong Kong primary school teachers who teach English as a second language (ESL). The data were collected from teachers’ design documents, game artefacts and written reflections. The findings revealed how different gamification approaches influenced teachers’ buy-in, identified their key dilemmas in implementation, and examined the factors affecting uptake and sustainable use of gamification.