The impact of Hybrid Competitive–Cooperative mechanics in digital board games on teacher efficacy for health policy education

Enhancing teacher efficacy through innovative educational technologies remains critical in modern pedagogy, particularly for complex subjects like health policy instruction. This experimental mixed-methods study evaluates the effectiveness of competitive-cooperative digital board games (CCDBGs) in improving teacher efficacy within K-12 health education settings in Taiwan. Adopting a pretest–posttest control group design, 184 teachers were randomly assigned to either a CCDBG workshop intervention group (n = 92) or an online instructional manual control group (n = 92). Quantitative analysis using generalized estimating equations demonstrated significant improvements in instructional preparation, pedagogical methods, and classroom atmosphere (p < 0.000), with effect sizes highlighting the intervention’s practical relevance. Qualitative classroom observations further revealed enhanced teaching engagement and instructional clarity, particularly in delivering complex topics such as Taiwan’s National Health Insurance system. The study bridges game-based learning theory with educational technology practice, showcasing how CCDBGs create dynamic, technology-enhanced learning environments that empower teachers. By integrating digital tools with collaborative-competitive mechanics, this research provides actionable insights for designing teacher training programs and advancing health policy education through innovative pedagogical frameworks. These findings position CCDBGs as a scalable solution for global educators seeking to leverage gamification and digital platforms to address curriculum challenges in technology-driven classrooms.