A digital mobile card-matching game called eFlip was developed to assist second-year undergraduate medical science students to learn core content and understand key associations in physiology. Our team developed customized content of core physiological associations, of increasing difficulty, for upload on a generic card-matching platform. The generic game was extended with add-ons coded to allow identification and access of student usage data for students who consented to have their game usage linked to academic performance such as final course marks and grades. Here, we describe the development of the eFlip game content, the student usage profile, and the game's impact on learning. Students were invited to use eFlip prior to and during the final examination period. Of those who used eFlip, 152 students consented to participate in a study of game use on learning performance outcomes. Within the students who consented, 74 played the game and 78 did not play the game (nonplayers). The mean course mark of the students who played the game [69.57%; 95% confidence level (CI) (67.22, 71.92)] was higher than that of the nonplayers [65.33%; 95% CI (62.67, 67.99)] (P = 0.02). Playing eFlip was also associated with reduced failure rates in students who played the game (1% failure rate) compared with the students who did not play the game (10% failure rate; P = 0.02). The number of games played by students peaked just prior to the course final examination. Overall, students who chose to play eFlip demonstrated improved grades that were associated with a higher probability of passing the physiology course.