Gamification and game-based learning have been used in the educational setting as an active learning strategy to increase student engagement. This study investigated the extent of the effect of gamification and game-based learning on student engagement of online Allied Health students in the Cultural and Ethical Influences course at Northwestern State University. This study also investigated the students' perceptions of using game-based learning in the online educational setting. A Fliphunt was incorporated into discussion board to establish the effect gamification would have on student engagement. This study also used an educational escape room to determine if gamification increased student test scores. Student perceptions were assessed using a researcher developed student perception survey. The results of this study were mixed. Since written posts were compared to video posts, and the two are incomparable, it was determined that this mode of measurement is not the best way to determine if game-based learning had an effect on engagement. Also revealed was no significant difference on test scores after the implementation of an escape room. Student perceptions were, however, positive. The results from the survey indicated students felt game-based learning was beneficial to the learning process and helped build engagement. Future studies on gamification and game-based learning are recommended. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]