Digital competence in health and nursing education: a cross-national comparison between samples from Germany and India using the DigKomp 2.2 questionnaire

Introduction: The digital transformation in healthcare requires future professionals to have solid digital skills. Despite the global relevance of digital skills, little is known about how these skills differ in countries with different healthcare and education systems. This study compares the self-assessed digital skills of two institutional samples of healthcare and nursing students in Germany and India using the DigKomp 2.2 questionnaire and examines the correlation between perceived competence and the strategies reported for searching for information. Methods: An online cross-sectional survey was conducted in April and May 2025 among 49 students in Germany and 256 students in India. Digital competences were assessed using the DigKomp 2.2 questionnaire, which covers all five dimensions of the DigComp framework. An open-ended question was used to record the students' strategies for searching for reliable information on the internet. The quantitative data were analyzed using the Kolmogorov-Smirnov test, the Levene test, and the t-test for two independent samples. Results: Both cohorts showed acceptable to high internal consistency across all DigKomp 2.2 dimensions. Students in the German cohort reported higher competencies in data processing and evaluation and communication/collaboration, while students from the Indian cohort scored higher in digital content creation, security and problem solving. The exploratory bivariate analysis between the Indian and German samples revealed significant differences in 7 out of 15 items, specifically within the dimensions of digital content creation (3/3 items), Security (2/3 items), data processing & evaluation (1/3 items), and problem solving (1/4 items), whereas no significant differences were found in communication/cooperation (0/2 items). Qualitative responses revealed structured and academically oriented search strategies among German cohort. Indian responses showed greater heterogeneity. Discussion: Digital competence development varies substantially between the two institutional samples, reflecting differences in educational structures, access to digital technologies and national digitalization trajectories. While German students demonstrate strong academically grounded competencies, Indian students exhibit strengths in practical and applied digital competence. These findings underscore the need for context-sensitive digital education strategies that combine structured research competencies with practical digital literacy to prepare students for increasingly digitalized healthcare environments in both countries.