This study investigated how different gamification elements in mobile apps influence users' basic psychological needs (autonomy, competence, relatedness) and subsequent engagement outcomes. Survey data was analyzed using PLS-SEM. Social gamification elements enhanced autonomy and competence needs, while immersive elements boosted autonomy and relatedness. Achievement/progression components increased competence and relatedness perceptions. Interestingly, personal traits did not significantly impact psychological needs. Crucially, satisfying autonomy and relatedness predicted higher user satisfaction and continued usage intentions, highlighting their importance for sustained engagement. Competence influenced satisfaction but not continuance intention. The findings demonstrate the motivational roles of distinct gamification features in fostering need-supportive experiences. Designers should incorporate varied social, immersive, and achievement components to address users' psychological requirements holistically. Prioritizing autonomy and relatedness support appears vital for achieving enjoyable, self-motivated, and persistent user engagement across gamified systems and domains. The study provides actionable insights for optimizing motivational affordances through psychologically-informed gamification implementations.

The COVID-19 pandemic measures have negatively impacted education worldwide via travel restrictions, student visas, and physical attendanc,e among many other fac-tors. As one of the first places to impose strict pandemic measures and one of the last places to lift the measures, Mainland China provided a unique venue to investigate the effect of public health pandemic control policies on tertiary education. Considering the large portion of international students in medical schools and the higher susceptibility to the pandemic measures due to the natural synergy with teaching hospitals, medical schools can be an early forefront indicator of the impact of the pandemic on tertiary education. We surveyed 513 participants international medical students from Wen-zhou Medical University’s school of international studies in 2019 and 2022 about their satisfaction and demographic and cultural adaptation parameters. We found that the pandemic restrictions did not generally impact student satisfaction. Further analyzing the associated parameters, we found teaching satisfaction to be independent of age (P=.159), years in China (P=.896) and Chinese Level (P=.577) in the medical university. Teaching satisfaction is associated with the region of origin (P <0.001), acceptance of local social norms (P <0.001), satisfaction with the core values of Chinese culture (P <0.001), acclimatization to life in China (P <0.001), can easily make Chinese friends (P <0.001) among other factors. The findings of this study provide an understanding of the effects of pandemic measures on tertiary education satisfaction and other factors that can aid in international student satisfaction.