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RESEARCH Open Access© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modif i ed the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit h t t p : / / c r e a t i v e c o m m o n s . o r g / l i c e n s e s / b y - n c - n d / 4 . 0 /.Wang et al. BMC Medical Education (2025) 25:316 https://doi.org/10.1186/s12909-025-06643-8IntroductionT h e lost wax casting technique is a fundamental com-ponent of dental laboratory courses for dental and den-tal technology students, as it is a traditional fabrication process used for dental prosthetics and appliances [1–5]. Th e accuracy and consistency of the casting operation are crucial for successful casting [6]. Mastery of the tech-nique requires frequent practice.However, there are areas for improvement in this teaching and learning process [6]. Inexperienced students performing casting in dental laboratories are at risk of wasting costly casting materials, experiencing explosions BMC Medical Education† YiZhen Wang and Yi Li considered as fi rst co-author.*Correspondence:MengWei Pangpmw@hospital.cqmu.com.cn1 College of Stomatology, Chongqing Medical University, No. 426, Songshi North Road, Yubei District, Chongqing, China2 Chongqing Key Laboratory of Oral Diseases, Chongqing Medical University, Chongqing, China3 Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China4 Key Laboratory of Virtual Reality Technology and systems, BeiHang University, Beijing, ChinaAbstractBackground A serious game module called “D-Casting” was developed in the previous study. This study aimed to determine the ef f ectiveness of the D-Casting module.Methods The experiment consisted of two parts: construct validity assessment and skill transfer assessment. Eligible participants, who were students majoring in dental and dental technology, were recruited from the Stomatology College of Chongqing Medical University. The intervention was designed based on the serious games assessment framework.Results The construct validity assessment recruited a total of 145 participants (100% response rate). The results suggested that D-Casting module could ef f ectively distinguish novice and experienced students (86.67[15.832] vs. 88.62 [11.252] vs. 82.24 [15.674] vs. 96.39 [8.419]; P < 0.001). The skill transfer assessment recruited a total of 78 participants (100% response rate). This assessment showed that the group combined with D-Casting for teaching and learning performed better than the control group in the casting process (82.26[13.711] vs. 89.64[6.796]; Z = -2.033; P = 0.042). The simple mediation analysis showed that the direct ef f ect from the instructing method to the scores of the casts was not signif i cant (95% CI − 3.45 to 2.98), but the indirect ef f ect (95% CI 3.42 to 12.39) and total ef f ect from the instructing method to the scores of the casts (95% CI 2.50 to 12.27; P = 0.004) were signif i cant.Conclusion This study determined construct validity and the skill transfer situation for the D-Casting module. Further multi-center experiments should be conducted to determine how skills are transferred through serious games.Keywords Casting, Validation study, Study skills, Dental educationEf f ectiveness evaluation of a serious game for dental lost wax casting trainingYiZhen Wang 1,2,3† , Yi Li 1,2,3† , ChaoYi Ma 1,2,3 , WeiYi Zhang 1,2,3 , ZiYa Yuan 1,2,3 , Qian Zhu 1,2,3 , XiaoHan Zhao 4 , Jinlin Song 1,2,3 , Sheng Yang 1,2,3 , Ping Ji 1,2,3 and MengWei Pang 1,2,3*