A digital serious game for brain health among first-year nursing students: An explanatory sequential mixed-methods...

Brain health is increasingly recognised as a public health priority, with relevance to prevention, healthy ageing and person-centred care. Student nurses require opportunities to engage with brain health early in preregistration education. Digital serious games may offer a brief, interactive and repeatable approach to introducing complex public health concepts.

To examine immediate educational outcomes and student experiences following use of a digital serious game on brain health with first-year preregistration nursing students.

An explanatory sequential mixed-methods design was used. First-year nursing students at a United Kingdom university used a digital serious game as an adjunct learning activity within a public health module. Pre- and post-gameplay questionnaires assessed attitudes towards brain health, self-efficacy and behavioural intentions. Post-gameplay evaluation assessed usability, satisfaction and relevance. Focus groups explored gameplay experiences and helped explain the quantitative findings.

Of 282 eligible students, 225 completed pre-gameplay questionnaires and 208 provided post-gameplay data; matched data were available for 197. Attitudes towards brain health increased significantly, with a large effect size (dz = 0.96, p < 0.001). Self-efficacy also increased significantly, with a small effect size (dz = 0.25, p < 0.001). Behavioural intentions showed a small, non-significant increase (dz = 0.12, p = 0.088). Post-gameplay evaluation was favourable, with a mean System Usability Scale score of 80.28/100; 76.9% awarded five stars and 97.6% agreed the game was useful for health promotion learning. Three focus groups with 25 students indicated movement from informal awareness to structured understanding, recognition of relational practice, and value of repetition and feedback.

The game was positively evaluated and associated with immediate improvements in attitudes and self-efficacy, but not behavioural intentions. Qualitative findings connected gameplay with self-care, patient education, relational practice and emerging professional identity. Research should examine retention, transfer and curriculum implementation.