Background:
The advancement of mobile game-based learning has encouraged many related studies, which, through the use of mobile 3-dimensional virtual reality, has enabled students to learn more and faster.To enhance the clinical path of cardiac catheterization learning, this paper has developed a mobile 3D Cardiac Catheterization Game-Based Learning System for cardiac catheterization.

Material and methods:
We designed an activity theory as a 3D mobile medical game-based learning system and evaluated the learning effectiveness, based on ARCS (Attention, Relevance, Confidence and Satisfaction) theory. Totally 102 students with the relevant medical background, divided into three groups (n = 34).This study implemented a quasi-experimental design at a medical college in south Taiwan, in the experimental stage, this study collects the questionnaire and test scores for learning achievement, learning motivation, medical anxiety and demographic variables in order to analyze group differences.

Results:
The learning achievements of this study show that the experimental group achieved higher scores than both control groups. The statistical analysis of the learning motivation and learning achievement shows ARCS-R (Relevance) as the most important factor, followed by of ARCS-C (Confidence).

Conclusions:
The results show that the learning content was relevant to the learner’s level, and that it brought more confidence and increased the effectiveness of learning.