Attitudes Toward and Preconditions for Digital Game-Based Learning Among Public Health and Health Sciences Students: Cross-Sectional Online Survey Study.

Abstract

Background: Digital game-based learning (DGBL) is gaining traction in medical and nursing education, but its integration into public health and health sciences curricula remains limited. This study addresses this research gap by exploring student perspectives, use patterns, and expectations regarding DGBL within German public health study programs.

Objective: The study investigated how public health and health sciences students perceive DGBL and identified conditions that promote or hinder its integration into academic training for public health professionals.

Methods: A cross-sectional online survey was conducted from January 2021 to March 2024. A total of 444 students participated, with 326 completing the questionnaire. The instrument combined closed- and open-ended questions on sociodemographic characteristics, digital media use, attitudes toward DGBL, and structural and pedagogical requirements. Quantitative data were analyzed descriptively using SPSS; qualitative data were evaluated using MAXQDA and Kuckartz structured content analysis.

Results: The sample consisted predominantly of full-time students enrolled in bachelor's or master's programs in public health and health communication. Digital media are widely used for communication (n=320, 98.2%), information search (n=291, 89.3%), and entertainment (n=268, 82.2%) in daily student routines. In contrast, video gaming and online shopping play a minor role. Students expressed a generally positive attitude toward DGBL, particularly in practical learning contexts such as exam preparation, visualizing complex content, and knowledge checks. High agreement was found for using DGBL in modules such as Prevention and Health Promotion (n=277, 84.9%), Epidemiology and Statistics (n=271, 83.2%), and Population Medicine (n=251, 76.7%). Preferred devices include desktop PCs, tablets, and smartphones, while immersive technologies such as virtual reality or augmented reality glasses or consoles are less favored. Students highlighted specific prerequisites for DGBL integration: a functioning technical infrastructure (n=321, 98.5%), media-literate teaching staff (n=311, 95.4%), and compliance with data protection standards (n=303, 93%). Furthermore, students valued user-friendly design (n=255, 78.2%), technical reliability (n=299, 91.7%), clear feedback (n=236, 72.4%), and flexibility regarding the time and place of use (n=307, 94.2%). Game elements such as animations, multimedia, and reward systems were appreciated, whereas features such as 3D graphics, avatars, and multiplayer modes were considered less important.

Conclusions: The findings show a high willingness among students to engage with DGBL, especially when its design emphasizes clarity, usability, and relevance to course content. Emotional safety, flexible access, and pedagogical integration are more decisive than immersive game features. To effectively implement DGBL in public health education, developers and educators should cocreate low-threshold, didactically sound applications that align with students' preferences and study realities. Future research should assess learning outcomes and emotional effects longitudinally and explore scalable implementation strategies.