LEGO^® SERIOUS PLAY^® as a Tool for Reflective and Sustainable Learning in Optometry

Abstract

This study examines the pedagogical potential of LEGO^® SERIOUS PLAY^® (LSP) in optometric education, aiming to foster critical reflection on optics, sustainability, and professional identity. A qualitative interpretative phenomenological analysis was conducted with 48 students from Optics and Optometry and Renewable Energies programs at ISEC Lisboa. Participants took part in LSP sessions focused on optics and sustainability, using metaphorical models to express their reflections. Data were collected via observations, group discussions, and open-ended questionnaires, and analyzed with Grounded Theory. In the optics theme, models revealed both scientific and symbolic views, with visual correction (46.7%), professional roles (21.3%), and perception (14.7%) being most frequent. Statistically significant differences appeared by academic background (p < 0.001) and experience (p = 0.0018): optometry students emphasized clinical roles, while environmental students highlighted perception. For sustainability, main categories included sustainable practices (41.7%), polluting industries (15.3%), ecological footprint (13.9%), and social responsibility (12.5%). Actions proposed included recycling, reuse, and biodegradable materials. Age was linked to action-oriented responses (p = 0.038), with no differences by gender or nationality. LSP emerged as an effective tool for deep reflection, interdisciplinary learning, and ethical engagement, supporting integration of sustainability and identity in technical education. Further research should explore its long-term educational impact.

1. Introduction

Innovative teaching methodologies have become increasingly vital in higher education, where learners are expected not only to master technical content but also to develop creativity, critical thinking, and ethical problem-solving skills. Traditional pedagogical approaches often fall short in addressing these multidimensional goals, leading to a growing interest in active, student-centered approaches that engage learners on cognitive, emotional, and social levels. Optics is a core scientific discipline that underpins numerous advances in vision science, physics, and technology (Born & Wolf, 2019; Jenkins & White, 2017). In optometric education, a solid understanding of optics is essential for accurate visual assessment, the diagnosis of refractive errors, and evidence-based patient care (Atchison & Smith, 2021). Despite its fundamental role, many students find optics challenging due to its abstract concepts and mathematical foundations. Recent research has highlighted the need for innovative teaching strategies to bridge the gap between theoretical content and practical application in optics (Clark et al., 2019; Penjor et al., 2022). However, the use of reflective, participatory, and creative methods, such as LEGO^® SERIOUS PLAY^® (LSP), remains largely unexplored in optics education.

One such method is LEGO^® SERIOUS PLAY^®, a structured, metaphor-based learning technique designed to foster personal insight, collective reflection, and deep conceptual understanding (Ferreira et al., 2024; Roos & Victor, 2018). Rooted in constructivist and constructionist learning theories (Papert & Harel, 1991), LSP involves building symbolic models with LEGO bricks, narrating their meaning, and collaboratively reflecting on those meanings (Ajibade & Hayes, 2022; Roos & Victor, 2018; Zenk et al., 2018). Far from being simple play, this hands-on process enables learners to externalize and articulate complex ideas through tangible representation and dialogue. Unlike many creative learning tools, LSP has a defined methodology with theoretical grounding in experiential and participatory learning. Kristiansen and Rasmussen (2014) outline its iterative four-stage process—posing questions, model building, storytelling, and reflection—as a way to surface tacit knowledge and enable shared understanding. James and Nerantzi (2018) highlight its value in democratizing classroom participation, while Schulz et al. (2015) demonstrate its efficacy in supporting systems thinking in complex domains such as healthcare and sustainability. It not only enhances cognitive engagement but also strengthens key social-emotional competencies such as communication, empathy, and teamwork, making it a powerful tool for navigating complexity in higher education (Moseley & Whitton, 2019; Peabody & Noyes, 2017; Wood, 2022). Yet, despite increasing adoption, the body of literature on LSP remains fragmented, with few comparative analyses across disciplines or critical evaluations of its limitations. For example, while Bulmer (2011) explores its use in engineering education to model technical systems, Garden (2022) examines affective dimensions in healthcare training. However, methodological transparency and pre-/post impact assessments are often limited, especially in fields like optometry, where their application is still largely absent. This gap suggests a need for empirical studies that not only describe LSP’s potential but also evaluate its educational outcomes.

When approached through a pedagogical lens, play emerges not as trivial amusement but as a profound and transformative mode of learning. Research has demonstrated that adult learners benefit from playful methods such as role-play, games, and metaphorical modelling (e.g., Elsawah, 2025; Heidari-Shahreza, 2024). These approaches foster critical reflection, stimulate creativity, and cultivate systems thinking by engaging learners cognitively, emotionally, and socially (Dann, 2018; Whitton, 2018). Among these, LSP stands out as a particularly robust methodology, offering a structured yet flexible environment that supports an inclusive, multisensory, and dialogic learning experience (Nerantzi & James, 2019). LSP invites participants to externalize internal constructs, articulate complex ideas, and explore diverse perspectives through the co-construction of shared narratives (James & Nerantzi, 2018; Kristiansen & Rasmussen, 2014; Nerantzi & James, 2019). Despite these documented strengths, most existing studies emphasize qualitative experiences rather than empirical assessment of learning gains, and few interrogate baseline competencies or the sustainability of the effects post-intervention.

The method’s iterative cycle—posing a question, building a model, sharing its meaning, and engaging in collective reflection—ensures equitable participation (Nerantzi & James, 2019). This process not only democratizes discourse in diverse learning communities but also enhances engagement by grounding abstract or technical content in tangible, personally meaningful representations. This method has proven successful across a wide range of domains, including engineering, healthcare, entrepreneurship, and education (Bulmer, 2011; Garden, 2022; Schulz et al., 2015; Warburton et al., 2022), supporting deeper engagement with complex systems and fostering a more personal connection with learning content. One of the most promising applications of LSP lies in education for sustainability, which demands systems thinking, ethical reasoning, and integrative problem-solving. Sustainability is not only a technical or scientific issue but also a deeply human and ethical concern that spans environmental, economic, and social dimensions (Mensah, 2019). Traditional lectures often fail to evoke the emotional and moral depth of such challenges. In contrast, LSP provides a resonant, learner-centered platform for exploring sustainability dilemmas, co-creating solutions, and reflecting on systemic interdependencies (López-Fernández et al., 2024; Pedregosa-Fauste et al., 2024; Zenk et al., 2018). However, the field lacks comparative studies on how LSP supports sustainability education relative to other pedagogical methods or how learners’ systems thinking evolves through such engagements. Through metaphor-based models, learners can explore real-world issues such as resource distribution, environmental degradation, or health disparities (López-Fernández et al., 2024). These visual metaphors function as cognitive anchors, enabling participants to engage with complex systems in a holistic and empathetic manner. By linking abstract concepts to personal values and lived experiences, LSP fosters not only comprehension but also a sense of responsibility and agency—critical attributes for those navigating the uncertain terrain of sustainable development (Benesova, 2023; Warburton et al., 2022). In sum, while LSP has demonstrated theoretical promise across diverse fields, its integration in optometric education remains under-researched, particularly with regard to the development of ethical reasoning, professional identity, and sustainability awareness. Moreover, the lack of baseline assessments or comparative frameworks in existing studies poses challenges for interpreting their pedagogical impact.

Despite its increasing adoption across various disciplines, the application of LSP in optometric and vision science education remains largely unexplored. This gap represents a significant missed opportunity, particularly given the ongoing transformation of the field in response to global health challenges and evolving societal expectations. Leading organizations such as the World Council of Optometry (WCO) and the World Health Organization (WHO) have emphasized the need for a shift toward competency-based education frameworks that prioritize not only clinical proficiency but also social responsibility, sustainability, and adaptive capacity (World Council of Optometry, 2024; Yu et al., 2023). In this context, LSP offers untapped potential as a pedagogical tool to support the development of future optometrists who are not only technically skilled but also ethically grounded, system-aware, and equipped to navigate the complex realities of contemporary eye care. To investigate this potential, it is necessary to first understand students’ baseline dispositions toward ethics, sustainability, and systemic thinking prior to LSP integration, an aspect that current literature lacks. Our study seeks to begin addressing this gap.

The field of optometry is undergoing rapid transformation, driven by shifting demographic patterns, accelerated digital innovation, and growing environmental concerns. The COVID-19 pandemic further catalyzed this evolution by normalizing remote care delivery, hybrid educational models, and the adoption of immersive technologies such as extended reality (XR) (Fortenbacher et al., 2018). While these technological advancements expand access and flexibility, they also risk minimizing the human dimensions of care, such as empathy and interpersonal communication. This calls for complementary pedagogical approaches that reintroduce reflection, dialogue, and ethical exploration into professional training. Within this context, LSP offers unique advantages. Its hands-on, narrative-driven, and metaphor-rich structure provides a powerful medium for optometry students to explore what it means to be a healthcare provider, how sustainability can be integrated into optical practices, and how their role fits within broader public health systems. Through metaphorical modeling and collaborative storytelling, students can externalize abstract concepts, examine ethical dilemmas, and situate their professional identity within systemic frameworks. LSP also supports holistic thinking, reflective learning, and active engagement, making it particularly effective for diverse learner cohorts, including those with varying levels of academic preparation or communication styles (Ganiyu et al., 2025; Nerantzi & James, 2019). Its adaptability enables seamless integration across curricular domains—ranging from the technical foundations of optics to the socio-ethical complexities of clinical decision-making. Furthermore, in multidisciplinary or culturally diverse classrooms, LSP fosters inclusive dialogue and mutual understanding, helping to level power dynamics and promote equity-centered learning environments (Jensen et al., 2018; Warburton et al., 2022).

While LSP is widely acknowledged for fostering engagement and creative group reflection, recent literature also highlights its limitations. For example, Wood (2022) discusses how LSP can be resource-intensive, requiring significant facilitator training and time investment, and notes that some learners may feel uncomfortable or less engaged with metaphor-based, hands-on activities. Similarly, Gauntlett (2018) and James and Nerantzi (2018) caution that the open-ended nature of LSP may lead to uneven participation and that empirical evidence of its long-term educational impact remains limited. Moreover, there is an ongoing debate about the robustness of assessment frameworks for LSP, making it difficult to compare learning outcomes with alternative reflective tools (Peabody & Noyes, 2017). By comparison, methods such as digital reflective journaling and peer feedback have demonstrated advantages in promoting individual critical reflection and are more easily integrated into blended or online learning environments (Morris, 2019; Taghizadeh Kerman et al., 2023). While LSP is unique in its multisensory and collaborative approach, recognizing these critiques and considering alternative methodologies provides a more balanced and comparative perspective on reflective learning in higher education.

In this study, we aim to assess the pedagogical value of LSP in optometric education by examining its capacity to support students’ development across three key domains: optics, sustainability, and professional identity. This involves an exploration of how students engage with these themes through metaphor-driven model-making and dialogue, and how these interactions contribute to reflective, systems-oriented learning. To address this aim, our research was guided by the following questions:

• How do students conceptualize optics and optometry after participating in LSP activities?
• In what ways do students reflect on sustainability issues within the context of optics and optometry?
• What are students’ perceptions of the benefits and limitations of the LSP methodology as a tool for reflective and interdisciplinary learning?
• Are there observable differences in reflections or conceptualizations based on students’ academic background, professional experience, or demographic characteristics?

To address these aims, and given the interdisciplinary composition of our sample, we specifically examined whether students’ academic background and professional experience were associated with distinct conceptualizations or reflections, as outlined in our fourth research question.

2. Materials and Methods

2.1. Study Design

This study employed a qualitative interpretative phenomenological approach (Saunders et al., 2009; Smith & Osborn, 2014), which is well-suited to exploring subjective experiences within innovative educational settings. This methodological choice is justified by the limited existing research on the integration of LSP in optometry education, especially regarding complex themes such as optics, sustainability, and the development of professional identity. The approach allows for an in-depth understanding of how participants construct meaning from their learning experiences (Taylor & Bogdan, 1986).

In this study, “constructing meaning” refers specifically to how students interpreted disciplinary knowledge (optics or sustainability) when faced with novel problem-solving contexts, and how these interpretations shaped their professional identity formation.

2.2. Sample

The study included 48 students from ISEC Lisboa (Higher Institute of Education and Science), with 41.7% enrolled in the Optics and Optometry program and 58.3% in the Renewable Energy and Environmental Engineering program, selected during the 2024/2025 academic year. Participants were intentionally recruited to represent both healthcare (optometry) and environmental/engineering perspectives, thereby ensuring a diverse and interdisciplinary cohort.

The rationale for this combination was not to assume “complementary perspectives” in a general sense, but rather to explore how students from different disciplinary backgrounds approached shared socio-scientific themes (vision science and sustainability) through the same pedagogical framework. While optometry students engaged more comfortably with optics-related concepts, and engineering students with sustainability challenges, the intention was to observe how disciplinary expertise influenced collaborative meaning-making when confronted with unfamiliar perspectives.

Detailed demographic and background characteristics (age, gender, nationality, and prior professional experience) are presented in the Results section. Students represented at least seven nationalities from different regions of the world. This diversity was not incidental; it was intentionally included to examine whether interpretations of socio-scientific issues, such as sustainability, differed according to cultural and geographical backgrounds. In the analysis, these differences were explicitly considered when comparing patterns of meaning-making across subgroups.

2.3. LEGO^® Serious Play Method Intervention

The pedagogical intervention was structured around the application of the LSP methodology to stimulate reflection and meaning-making on two core themes: (1) Optics and (2) Sustainability. The aim was to explore the integration of these themes into professional practice. The LSP process followed its fundamental sequential four-step model—build, share, reflect, and integrate—, designed to foster critical thinking, teamwork, creativity, and problem-solving (Figure 1).

In practice, students first built individual models to represent disciplinary concepts, then explained their models to peers, and finally engaged in group reflection to connect individual contributions into a collective model. These phases were structured using the “Four Cs” model—Connect, Construct, Continue, Contemplate—with explicit prompts guiding students to move from personal reflection to collaborative synthesis (Figure 2).

2.4. Data Collection

Data collection methods included participant observation, discussions, and an open-ended questionnaire (

Table 1. Post-intervention student questionnaire. Source: adapted from Pedregosa-Fauste et al. (2024).

No.	Question
1	How would you evaluate the effectiveness of the LSP methodology in this exercise?
2	What was your overall experience with the LSP methodology during this exercise?
3	How did you experience the construction process using LEGO® pieces? What thoughts or reflections arose during this process?
4	How would you assess the level of difficulty associated with the LSP methodology in this exercise?
5	What limitations or challenges did you encounter while engaging with the LSP methodology in this exercise?

) designed specifically for this study and aligned with the “Four Cs” model.

LSP sessions were held in-person at ISEC Lisboa during the spring semester of the 2024/2025 academic year. Students participated in 18 groups of 2–3 members, each session lasting approximately 90 minutes. A trained facilitator guided the sessions, introducing the LSP methodology, explaining the reflective tasks, and ensuring a supportive environment. Throughout the sessions, the facilitator conducted systematic participant observation using structured field notes to record verbal and non-verbal interactions, group dynamics, and notable moments of reflection or challenge.

Group discussions and brief in-depth interviews followed each building activity, allowing students to elaborate on the meanings of their LEGO^® models and reflect collectively on the learning experience. All discussions and interviews were audio recorded (with informed consent) and subsequently transcribed verbatim. The post-intervention questionnaire was administered immediately after the final session to capture individual perspectives in writing.

To ensure data quality and depth, triangulation was achieved by comparing insights from observations, transcribed group discussions/interviews, and questionnaire responses. All procedures were approved by the institutional ethics board, and confidentiality and voluntary participation were emphasized throughout the process.

2.5. Data Analysis

Data were analyzed using a Grounded Theory approach (Belgrave & Seide, 2019; Wuetherick, 2010) within an interpretative-critical paradigm (Lecaldano, 2022), providing an interdisciplinary perspective that integrates optics and sustainability. The analysis process comprised a three-stage process (Belgrave & Seide, 2019; Wuetherick, 2010): open coding, axial coding, and selective coding, aimed at generating abstract thematic categories. The analysis was conducted by the authors and continued until theoretical saturation was achieved, ensuring comprehensive representation of the emerging themes.

For quantitative analysis, the qualitative data from each participant (obtained through observations, group discussions, and open-ended questionnaires) were systematically coded into a structured matrix (Excel spreadsheet), where each conceptual category (e.g., “visual correction”, “recycling”, “renewable energy”) was recorded as a dichotomous variable (presence/absence) for each individual. This coding enabled the quantification of category frequencies and the construction of contingency tables for statistical analysis.

Although the primary design of this study is qualitative, we integrated complementary quantitative analyses to enhance the interpretation of qualitative patterns and explore associations between participant characteristics and emergent categories. Descriptive statistics were used to characterize the sample. To examine potential relationships between sociodemographic variables (e.g., academic background, nationality, age) and the conceptual categories identified in the LSP activity, we applied chi-squared tests to contingency tables and one-way ANOVA to explore differences in age across categories. Tukey’s HSD post hoc test was used when appropriate, and standardized residuals were examined for further interpretation. This included subgroup comparisons (e.g., by academic background and professional experience) to explore whether participants from different disciplines or with varying levels of work exposure approached key concepts differently. These comparisons were undertaken in direct response to our research question on the influence of participant characteristics. All quantitative analyses were conducted in R (version 4.4.2), with a significance level set at α = 0.05. This mixed-methods integration follows established recommendations in educational research, where targeted quantitative measures are used to support and deepen qualitative insights, rather than to generalize findings to broader populations (Creswell & Plano Clark, 2007).

2.6. Criteria for Rigor

To ensure methodological rigor, the study followed the criteria established by Guba and Lincoln (1994): credibility, transferability, dependability, and confirmability. Credibility was addressed through triangulation of data sources (including observations, group discussions, and questionnaires), peer debriefing among the research team, and member checking with participants to validate key findings. Transferability was supported by providing rich, contextualized descriptions of the setting, participant backgrounds, and the implementation of the LSP process, allowing readers to judge the relevance of results to other contexts. Dependability was achieved by maintaining an audit trail of methodological decisions, coding procedures, and analytical steps throughout the research. Confirmability was strengthened through systematic documentation of the analysis process, use of reflexive memos, and collaborative coding among multiple researchers to minimize bias. The study also adhered to the COREQ checklist (Tong et al., 2007) to enhance transparency and reporting quality.

2.7. Ethical Considerations

All participants provided informed written consent after being fully briefed on the study’s purpose, the confidentiality of their data, and their right to withdraw at any time prior to data analysis. Ethical sensitivity was particularly important given the reflective and personal nature of the LSP activities, where participants shared both individual and collective experiences. Ethical protocols were followed to ensure privacy, respect for autonomy, and voluntary participation throughout the research process.

3. Results

The analytical process was informed by our guiding research questions and existing literature on reflective learning in higher education. While the study was exploratory in nature, we expected, based on prior research (e.g., Kristiansen & Rasmussen, 2014; Garden, 2022), that students’ academic backgrounds and prior professional experience would shape not only the content but also the framing of their responses during the LSP activities. This expectation guided our comparative analysis across subgroups, seeking to identify how disciplinary identity and prior experience might influence conceptualizations of optics, sustainability, and professional identity.

A total of 48 students participated in the study, representing two academic programs: Optics and Optometry (n = 20) and Renewable Energies and Environment (n = 28). The participants had a mean age of 28.6 years (SD = 11.1), with a median of 24.5 years and an interquartile range (IQR) of 13.5. In terms of gender distribution, 25 students (52.1%) were women and 23 (47.9%) were men. The sample was internationally diverse. Most participants were from Portugal (n = 29; 60.4%), followed by Angola (n = 9; 18.8%), Brazil (n = 3; 6.25%), and Guinea (n = 3; 6.25%). Smaller representations came from Spain (n = 2; 4.17%), China (n = 1; 2.08%), and São Tomé and Príncipe (n = 1; 2.08%). Regarding professional experience, 13 students (27.1%) reported working in the field of optics at the time of the study, while the remaining 35 students (72.9%) were not employed in that sector.

To ensure analytical rigor, qualitative data from observations, group discussions, and questionnaires were independently coded by two researchers. Open, axial, and selective coding were used, with discrepancies resolved by consensus, and analysis continued until thematic saturation was reached.

3.1. Category Construction

During the sharing phase of the LSP activity, students’ interpretations of their constructions were systematically recorded and analyzed. This qualitative analysis led to the identification of several key conceptual categories related to optics and optometry, reflecting scientific (such as “physics-light interaction” or “optics in everyday life”), professional (including “visual correction,” “professional activity” in varied contexts such as stores, exams, consulting rooms, workshops, and teamwork), and symbolic dimensions (such as “seeing the world” or “helping others”). These categories demonstrate the richness and multidimensionality of students’ conceptualizations of the field, spanning from technical knowledge to more personal and ethical perspectives.

In the second challenge, focused on sustainability in optics, students’ models and narratives further expanded the thematic range, giving rise to categories that encompassed environmental (e.g., “sustainable practices” like recycling, saving water, or use of renewable energy; “sustainable materials” such as bioplastics, wood, or glass), social (“second use/social responsibility” through donation, repair, or redistribution), and economic issues (like “economy/fair payments” and the critique of the “polluting industry”). Notably, models often moved beyond simple critique of environmental impact, incorporating proposals for concrete solutions and highlighting the complexity and interconnectedness of sustainability challenges in the field of optics.

These categories were constructed with systematic coding procedures and peer discussion, ensuring that results reflect both descriptive breadth and interpretative depth, rather than casual observation. This dual categorization, covering both optics/optometry and sustainability, reflects the effectiveness of the LSP methodology in eliciting not only knowledge recall but also critical reflection and systems thinking among participants. The breadth of categories also suggests that students were able to integrate their disciplinary background, professional aspirations, and personal values when responding to the challenges posed. This approach allowed us to identify both convergent and divergent patterns across the sample, in line with our initial hypotheses regarding subgroup differences.

Table 2. Conceptual categories emerging from LEGO^® SERIOUS PLAY^® models on optics, optometry, and sustainability.

Concept	Category	Subcategories	Description
Optics and optometry	Physics-light interaction	–	Optics as a branch of physics that studies the interaction between light and matter.
	Optics in everyday life	–	Associations with everyday devices such as cameras, telescopes, and medical tools.
	Visual correction	–	Optics understood as the practice of improving visual capacity through lenses or other instruments.
	Professional activity	Store, Exams, Consulting room, Workshop, Teamwork	Optics as a profession, including clinical, commercial, technical, and collaborative contexts.
	Seeing the world	–	Optics as a symbolic or metaphorical lens for understanding and interpreting reality.
	Helping others	–	Optics as a means to support well-being and improve others’ quality of life.
Sustainability in optics and optometry	Sustainable practices	Recycling, Reusing, Saving water, Renewable energy	Daily actions that promote sustainability in optical practice.
	Sustainable materials	Recycled materials, Bioplastics, Cork, Wood, Glass, Biodegradable options	Environmentally friendly materials used in optical production and services.
	Second use/Social responsibility	Donation, Repair, Redistribution	Promoting equity and reuse in optical products and services.
	Ecological footprint	–	Reflection on the environmental consequences of optical practices.
	Polluting industry	–	Critique of the optics sector as environmentally harmful or lacking recycling.
	Problem identification and solution	–	Models that presented a sustainability issue and proposed a concrete solution.
	Economy/Fair payments	–	Ethical and economic considerations related to pricing, wages, and fairness.

presents the complete set of conceptual categories and subcategories that emerged from the analysis.

3.2. What Is Optics and Optometry?

Students’ responses to “What is optics and optometry?” reflected a rich interplay between technical expertise and broader professional identity (Figure 3). Nearly half of participants (46.7%, n = 35) associated optics primarily with visual correction, emphasizing the core clinical and technical dimension at the heart of optometric practice. This dominant theme underscores the continued relevance of traditional competencies in the minds of students, validating the importance of foundational clinical training.

However, the results also reveal that students’ conceptualizations were far from monolithic. A significant proportion (21.3%, n = 16) referenced professional activity, detailing the diversity of roles and contexts in which optometrists work. Responses within this category (n = 72 total) mapped out the full spectrum of professional environments: consulting rooms (31.9%, n = 23), exams (26.4%, n = 19), stores (22.2%, n = 16), workshops (13.9%, n = 10), and teamwork (5.6%, n = 4). This variety not only highlights the multi-faceted nature of optometric work but also reflects students’ anticipation of dynamic, collaborative careers that go beyond clinical tasks alone.

Perhaps most notably, a meaningful segment of students (14.7%, n = 11) moved beyond technical or professional descriptions, invoking more metaphorical or existential perspectives such as “seeing the world.” These responses point to an emerging recognition of optics as a lens for interpreting reality, hinting at the reflective and humanistic dimensions that advanced pedagogies like LSP are designed to surface.

Interpretatively, the influence of academic background and prior professional experience is especially revealing. Students in the Optics and Optometry program, and those with direct work experience, tended to emphasize traditional clinical roles and the importance of helping others—demonstrating how curricular focus and hands-on exposure reinforce established professional narratives (academic background: χ² = 33.70, df = 5, p < 0.001; professional activity: χ² = 19.19, df = 5, p = 0.0018). In contrast, students from Renewable Energies and Environment, or those without optics experience, were more likely to connect optics to everyday applications and to broader, often abstract, themes of perception. This divergence highlights how disciplinary and experiential context shapes not just what students know, but how they frame and value that knowledge, a key insight for the design of interdisciplinary or reflective curricula. While differences between academic background and professional experience might be anticipated, these findings empirically demonstrate how curriculum and prior work exposure concretely shape students’ conceptualizations in a real educational context.

Importantly, no significant differences were found by age, gender, or nationality, suggesting that these more nuanced and multidimensional understandings are primarily a function of educational and professional trajectory, rather than demographic back-ground. Overall, these subgroup analyses provide empirical support for our hypothesis that academic and experiential background influence the depth and focus of student reflections. In sum, these findings demonstrate that reflective and participatory learning activities can reveal both the technical and the existential dimensions of professional identity in optometry students. They underscore the importance of including such methodologies in the curriculum to foster critical and personal engagement with the discipline.

The LSP constructions themselves vividly embodied this spectrum of conceptualizations (see Figure 4). Students created models ranging from detailed clinical environments and instruments to abstract forms representing vision as a gateway to new understanding, or as a catalyst for human connection. The diversity in color, shape, and arrangement reflects not just varied technical knowledge but also personal, ethical, and relational perspectives. This reinforces the value of hands-on, metaphor-based pedagogies in eliciting deeper layers of meaning that might remain unspoken in traditional classroom discourse.

To exemplify the range and integration of student thinking, the following illustrative quotations, classified via the SOLO taxonomy, demonstrate progression from technical to abstract conceptualizations:

• “Optics is how we understand reality—it’s not just about eyes, it’s about perspective.” (Relational/Extended Abstract);
• “A gateway to helping people see better and live better.” (Multistructural/Relational);
• “This is more than a clinic—it’s a place where clarity unfolds.” (Relational).

These responses capture a movement from simple, functional definitions to more holistic, integrated, and even existential understandings of the field. Some students remained anchored in the technical core, while others articulated a vision of optometry as both science and a framework for engaging with the world, demonstrating the power of reflective, participatory methodologies in shaping professional identity. Overall, these findings reinforce the importance of integrating reflective and participatory methods in optometric education, as they enable students to bridge technical knowledge with personal and ethical meaning, a process that is vital for professional identity formation and the development of future-ready practitioners.

3.3. What Does Sustainability Mean in Optics and Optometry?

Students’ responses revealed a nuanced and multidimensional understanding of sustainability within the context of optics and optometry. As shown in Figure 5, the most frequent theme was “sustainable practices,” cited by 41.7% (n = 30) of students, underscoring a practical orientation toward everyday actions such as recycling (n = 19; 35.2%) and reusing materials (n = 19; 35.2%), as well as saving water (n = 9; 16.7%) and using renewable energy (n = 7; 13.0%). This prevalence of actionable practices suggests that, for many participants, sustainability is primarily conceptualized as a set of tangible behaviors that can be incorporated into daily professional routines.

Other key categories included “polluting industry” (15.3%, n = 11), where students voiced concern about the environmental impact of optical manufacturing and lack of recycling, and “ecological footprint” (13.9%, n = 10), reflecting awareness of the broader environmental consequences of professional activity. “Second use/social responsibility” (12.5%, n = 9) was also prominent, highlighting the importance some students placed on ethical redistribution, donation, or repair of optical products as ways to promote equity.

Within the category of “sustainable materials” (n = 74 total references), students identified recycled materials (n = 24; 32.4%), materials that can be recycled or reused (n = 16; 21.6%), and machines (n = 16; 21.6%) as key to advancing sustainability in optics. There was also mention of wood/cork (n = 6; 8.1%), biodegradable materials (n = 6; 8.1%), and, to a lesser extent, bioplastics, glass, and plastic (each n = 2; 2.7%). The variety here shows that students not only recognized the importance of recycling but also considered the properties and origins of materials as central to ethical professional practice.

Interpretatively, these findings indicate that students are capable of integrating both environmental and social dimensions into their conceptualization of sustainability. Notably, statistical analysis showed that academic background significantly influenced students’ focus (χ² = 15.34, df = 6, p = 0.018): those from Renewable Energies and Environment were more likely to emphasize ecological footprint (n = 10; 13.9%) and environmental impacts, while students from Optics and Optometry were more likely to focus on social responsibility (n = 9; 12.5%) and critique polluting industry (n = 11; 15.3%). This pattern suggests that disciplinary context shapes not only the content but also the ethical framing of sustainability concerns, a point echoed in previous literature about the value of interdisciplinary approaches in health education.

Age differences were also observed: students who linked sustainability to practical actions such as recycling or reusing materials tended to be older (p = 0.038), suggesting that life or work experience may support a shift from abstract environmental awareness toward concrete behavioral strategies. In contrast, no statistically significant differences emerged by nationality, gender, or professional activity, indicating that sustainability concerns cut across these lines. Taken together, these results show that the LSP intervention made visible both “surface” and “deep” conceptualizations of sustainability, supporting the hypothesis that hands-on, reflective methods can elicit a wide spectrum of student perspectives.

The diversity of LSP constructions (see Figure 6) mirrored these thematic findings. Models ranged from visual critiques—such as optical machines surrounded by dark bricks to represent pollution—to creative solutions, such as interconnected elements symbolizing material cycles, reuse, and collaboration. This variety reflects both critical awareness of industry shortcomings and a constructive orientation toward improvement.

Illustrative quotations provide further insight into the range and depth of student thinking:

• “Sustainability is about using what already exists in a smarter way—it’s not always about buying new.”
• “We have a duty, not just to improve vision, but to avoid harming the planet in the process.”
• “If we don’t consider materials, waste, and energy in our practice, we’re missing the bigger picture.”

These responses demonstrate that many students recognize the complex, systemic nature of sustainability and see professional responsibility as inseparable from ethical and environmental stewardship. The ability to move between practical solutions and more abstract reflections shows that LSP enabled students to access and articulate both “surface” and “deep” understandings of sustainability. Thus, the combination of systematic qualitative analysis and targeted quantitative comparisons reinforces the credibility and depth of our findings, addressing both descriptive variety and theoretical integration in line with educational research best practices.

3.4. Students’ Reflections on the LEGO^® SERIOUS PLAY^® Methodology

Transcriptions of group discussions and observations were analyzed using the same coding structure as the questionnaire responses, enabling triangulation and reinforcing the robustness of the emerging themes. Students’ feedback on the LSP methodology revealed a rich combination of enthusiasm, critical reflection, and constructive critique. Many described their experience with LSP as both engaging and transformative, frequently contrasting it with more conventional, passive learning environments. Words such as “active,” “stimulating,” and “a creative way of learning” were recurrent, suggesting that LSP fostered a higher level of cognitive and emotional involvement. This indicates that hands-on, metaphor-driven activities can unlock types of reflection and engagement that are rarely reached through traditional academic methods.

A recurrent theme was the distinctive value of “thinking and expressing through your hands.” Several students reported that manipulating the LEGO pieces helped stimulate creative thinking and fostered the emergence of new ideas:

| “The pieces help ideas flow—one leads to another.”

Collaboration was also widely appreciated. Many participants highlighted that group work facilitated brainstorming, problem-solving, and the collective development of ideas—even when differing opinions initially existed:

| “Even with opposing views, we found ways to build something together.”

This collaborative aspect was perceived as not only supporting peer learning but also as creating a safe space for personal reflection and more meaningful engagement with content. Such findings are consistent with the literature on LSP’s ability to democratize participation and foster the co-construction of knowledge. Nevertheless, several students identified practical limitations inherent to the method. The most frequent complaint concerned the limited variety or number of LEGO pieces, which sometimes made it difficult to precisely represent abstract concepts:

| “Not finding the right pieces was frustrating, even if it made you invent.”

Others pointed out that translating complex or abstract ideas into physical models required effort and ingenuity, and that time constraints occasionally added pressure:

| “The third challenge was the most difficult, because we had to combine two different concepts that don’t easily fit together.”

Despite these challenges, the majority of students (n = 10; 20.8%) expressed a positive overall evaluation of LSP. Many reported that the methodology helped consolidate ideas (n = 5; 10.4%), connect theory to practice (n = 5; 10.4%), and explore new ways of thinking (n = 6; 12.5%). Several students advocated for broader use of LSP in education (n = 3; 6.25%), emphasizing its emotional impact and memorability:

| “It’s something you remember, because it’s different—and it stays with you.”

In line with our analytic framework, these reflections support the conclusion that LSP can promote both group engagement and individual metacognition, while also surfacing practical barriers to implementation.

Interpretatively, these reflections suggest that LSP not only enriches the educational experience by fostering creativity, collaboration, and metacognitive awareness but also facilitates more lasting engagement with learning. At the same time, the reported challenges highlight the need for careful facilitator training, sufficient resources, and thoughtful session design to maximize the benefits of the method. In summary, the students’ reflections corroborate previous findings on the added pedagogical value of LSP and provide evidence that, when carefully implemented, such approaches can significantly enhance both individual and collective learning outcomes in higher education. Although some student reflections may appear self-evident or enthusiastic, their recurrence underscores the value of participatory, hands-on methods in fostering engagement and deeper learning. The identified limitations, such as resource constraints and challenges in abstract modeling, offer important insights for the future refinement of LSP and similar pedagogical approaches.

4. Discussion

This study provides a nuanced analysis of how LSP can be leveraged to foster conceptual understanding, systems thinking, and professional identity formation in optometric education, with a special emphasis on sustainability. Our results both align with and extend existing research, while also surfacing areas where LSPs’ value and limitations become evident in multidisciplinary higher education contexts.

Our first key finding, that students conceptualized optics across clinical, technical, and symbolic-existential dimensions, mirrors observations by Kristiansen and Rasmussen (2014), Zenk et al. (2018), and Ganiyu et al. (2025), who all report that LSP allows learners to externalize both technical knowledge and personal meanings. In our study, the frequent association of optics with visual correction reflects the ongoing importance of core competencies in optometric education, as also noted by Atchison and Smith (2021) and Clark et al. (2019), who document students’ struggles to move beyond a narrow technical focus. However, the emergence of categories such as “seeing the world” and “helping others” underscores LSP’s ability to foster holistic thinking—a result supported by James (2013), who found that healthcare students using LSP articulated professional values and empathy more readily than in traditional didactic settings.

Similar to the findings of Peabody and Noyes (2017) in engineering, and Garden (2022) in health sciences, our students created models that went beyond the functional—representing optometry as a means for societal connection and ethical practice. This supports the argument that metaphor-based, hands-on methods facilitate not only knowledge acquisition but also professional identity development and ethical reasoning, crucial for today’s health professionals (Papert & Harel, 1991; Kristiansen & Rasmussen, 2014; Warburton et al., 2022).

A distinctive contribution of our research is the comparative analysis across academic backgrounds. The statistically significant association between disciplinary cohort (optometry vs. renewable energies/environment) and conceptual categories is consistent with Ferreira et al. (2024) and Jensen et al. (2018), who also found that LSP surfaces disciplinary framings and divergent approaches to problem-solving. While optometry students in our cohort gravitated toward clinical, patient-centered models, their peers from sustainability backgrounds emphasized ecological impact and systemic thinking—paralleling Warburton et al. (2022), who showed similar patterns among business and environmental students.

Interestingly, no significant effects were found for gender or nationality, which is in line with Ganiyu et al. (2025), but diverges from some studies in medical education where cultural context influenced reflective outcomes Zenk et al. (2018). The lack of impact from professional activity (current work in optics) contrasts with findings from Benesova (2023), who noted that prior clinical experience often deepens reflection; however, it aligns with Warburton et al. (2022), who argue that group dynamics and activity design may outweigh individual experience.

Our participants’ rich, actionable conceptualizations of sustainability (“recycling,” “reuse,” “fair payment,” etc.) extend the work of López-Fernández et al. (2024) and Pedregosa-Fauste et al. (2024), who found that LSP prompts concrete, real-world problem-solving and ethical reflection. The prevalence of themes such as “polluting industry” and “ecological footprint” is notable: while many LSP studies report surface-level engagement with sustainability (Benesova, 2023), our results suggest that, given a targeted prompt, students can articulate both the challenges and propose solutions—supporting Zenk et al. (2018), who advocate for LSP in systems education.

The disciplinary split—where environmental students focused more on systemic and ecological issues, and optometry students on social responsibility—mirrors findings in Warburton et al. (2022) and Ferreira et al. (2024), where LSP facilitated cross-pollination of perspectives. However, as in those studies, truly integrated, transdisciplinary models were less frequent, suggesting that while LSP can open dialogue, it does not automatically lead to full integration of perspectives.

Our finding that older students emphasized actionable sustainability practices (recycling, reuse) is consistent with Ganiyu et al. (2025), who observed that mature learners favor concrete, experience-based strategies. This may reflect life or work experience shaping problem-solving approaches—a trend also described by Dann (2018).

Students described LSP as engaging, memorable, and conducive to creative thinking—findings in line with Kristiansen and Rasmussen (2014), Nerantzi and James (2019), and Pedregosa-Fauste et al. (2024). The reported challenges (e.g., limited variety of pieces, frustration with abstract modeling, time constraints) echo critiques raised by Wood (2022), Gauntlett (2018), and Peabody and Noyes (2017). These limitations, along with the resource- and time-intensive nature of LSP, suggest it may not always be practical as a core pedagogical method, but is valuable as a supplement to more scalable reflective approaches such as digital journaling or structured peer feedback (Morris, 2019; Taghizadeh Kerman et al., 2023).

Comparing LSP to these alternatives, our results suggest that while LSP excels at fostering group reflection, creative modeling, and collaborative dialogue, it is best used alongside methods that promote individual critical thinking, are easily scalable, and support ongoing assessment. The lack of empirical data on long-term impact and learning outcomes remains a challenge for the field (Wood, 2022; Peabody & Noyes, 2017).

This study presents several notable strengths. First, it is among the few empirical investigations to apply LSP in optometric education, particularly integrating sustainability themes and interdisciplinary cohorts. The mixed-methods design—combining in-depth qualitative analysis with targeted quantitative comparisons—provided a nuanced understanding of how academic background, age, and professional experience shape conceptualizations of optics and sustainability. The use of rich, triangulated data (observations, group discussions, and questionnaires) enhanced the credibility and depth of the findings.

Nevertheless, certain limitations must be acknowledged. The sample was restricted to a single institution and limited in size, potentially affecting the generalizability of results to other educational or cultural contexts. While the integration of students from both optometry and environmental engineering programs enabled valuable disciplinary comparisons, the unequal distribution of participants across groups could introduce bias. Furthermore, as participation in the LSP sessions was voluntary, there may be an element of self-selection toward more motivated or reflective students. The qualitative nature of the primary design, while allowing deep exploration, means that statistical analyses were used only to support and contextualize findings rather than to generalize to broader populations. Finally, the absence of long-term follow-up prevents assessment of the durability of learning or attitudinal changes induced by the intervention.

Another limitation relates to the role of individual player profiles in the effectiveness of gamified interventions. The effectiveness of gamification in educational settings does not depend solely on the design of game dynamics, but also on their suitability to the player profile of participants, which is closely related to personality factors (Vergara et al., 2022, 2023). Recent studies highlight that tailoring gamification to the player profile, such as according to Bartle’s typology (Explorer, Socializer, Killer, Achiever), can increase motivation, engagement, and academic performance, particularly in higher education (Vergara et al., 2022, 2023). However, the literature also points out a certain mismatch between the predominant player profile of university teaching staff and that of their students, with instructors being mostly “Explorers” and students “Achievers,” which could limit the effectiveness of gamified strategies if this difference is not taken into account (Vergara et al., 2022, 2023). Therefore, it is recommended that the design of gamified experiences should begin with a prior analysis of both user profiles and learning objectives (Vergara et al., 2023). In the present study, the player profile of students and its potential impact on learning outcomes were not evaluated, which constitutes a relevant limitation and a promising avenue for future research aimed at optimizing the personalized design of gamified interventions according to user profiles (Vergara et al., 2022, 2023).

Future research should address these limitations by expanding the study to multiple institutions, increasing sample diversity, and incorporating longitudinal designs to evaluate lasting impacts on professional identity, systems thinking, and sustainable practice. Comparative studies evaluating LSP alongside alternative reflective or participatory methods would also be valuable for clarifying its unique contributions and optimal applications.

Practically, these findings suggest that LSP can be a valuable complement to traditional teaching in optometry, especially for fostering reflection on complex, interdisciplinary topics such as sustainability. Educators should consider integrating LSP in combination with other reflective tools, while ensuring sufficient resources, facilitator training, and curricular alignment to maximize its benefits.

Implications of the Study

The findings of this study highlight several actionable implications for optometry education and related disciplines. Integrating participatory, metaphor-based methods like LSP can promote not only content mastery but also foster systems thinking, ethical reflection, and professional identity formation—especially on complex topics such as sustainability. Combining LSP with other reflective approaches (e.g., digital journaling, peer feedback) may help address diverse learning preferences and improve scalability for larger student cohorts.

Institutions should consider investing in facilitator training and adequate resources to ensure the successful implementation of LSP. The positive feedback from participants and increased engagement observed in this study suggest that LSP can enhance student motivation and enrich the learning experience, potentially leading to better academic and professional outcomes.

On a broader scale, adopting innovative, student-centered teaching strategies such as LSP can help align educational programs with evolving priorities in healthcare, including sustainability and social responsibility. Embedding these approaches into curricula may better prepare future professionals for leadership roles in increasingly complex and interdisciplinary settings.

Finally, further research is needed to explore the long-term impacts of LSP and similar methods, as well as their adaptability across different educational contexts and healthcare professions.

5. Conclusions

The findings of this study provide significant insights into the pedagogical value of LSP in optometric education, particularly in promoting critical reflection across domains such as optics, sustainability, and professional identity. By engaging students in metaphorical construction and collaborative dialogue, the LSP methodology enabled the articulation of both technical and symbolic dimensions of optometry and its broader social implications.

The learning process observed during LSP sessions unfolded across six distinct phases: initial curiosity, unexpected engagement, a sense of achievement, the construction of new knowledge, consolidation of learning, and a final stage characterized by fulfillment and equilibrium. These stages underscore how playful learning can evolve into a deeply meaningful, emotional, and transformative educational experience.

However, this study is not without limitations. The sample was restricted to a single institution and relatively small in size, which may affect the generalizability of the findings to other educational or cultural contexts. Participation was voluntary, introducing the possibility of self-selection bias toward more motivated or reflective students. Additionally, students reported difficulties in representing abstract concepts due to the limited variety or quantity of LEGO bricks, as well as time constraints during the sessions. These challenges highlight the importance of thoughtful facilitation and adequate resource planning in order to fully leverage the method’s potential.

To strengthen future research, larger and more diverse samples should be included, encompassing different academic years, institutions, and cultural backgrounds. Stratified sampling could help ensure proportional representation of relevant subgroups, thereby enhancing the generalizability of findings. Additionally, longitudinal studies would be instrumental in assessing the enduring impact of LSP on students’ professional development, ethical reasoning, and systems thinking.

Ultimately, LSP is more than an innovative pedagogical tool; it is a powerful medium for fostering personal, professional, and social development. Its implementation into optometric education may contribute to forming reflective, collaborative, and socially conscious practitioners, well-equipped to navigate the ethical and systemic complexities of contemporary vision care.