Readiness for digital case-based learning in Community Medicine: a multi- institutional cross-sectional needs assessment of undergraduate medical students in India

Abstract Background Community Medicine asks medical students to reason from an individual case to action at family, community and programme level, but teaching in India still relies heavily on lectures and field visits. Digital case-based learning (DCBL) could give students repeated, structured practice in this kind of reasoning. Learner needs are rarely assessed before such modules are built. We assessed students’ self-rated confidence in clinical reasoning, learning preferences, digital access, barriers and interest in DCBL, and identified factors associated with high interest. Methods We conducted a cross-sectional online survey between 10 July 2025 and 29 June 2026 among undergraduate medical students and interns at five medical colleges in four southern Indian states. The questionnaire combined 5-point ratings, multiple-response items and open questions. High interest (rating 4–5) was modelled using multivariable logistic regression, with an ordinal model as a sensitivity analysis. Free-text responses were analysed using content analysis. Results Of 906 responses, 860 were analysed. Of these, 28.0% rated their confidence in applying clinical reasoning to public-health problems as high; 53.4% chose the midpoint. Students learned best through clinical postings and field visits (64.7%), case-based learning (48.3%) and problem-based learning (43.6%); 30.0% chose classroom lectures. Most used a smartphone or tablet (91.9%). The commonest barriers were lack of motivation (35.1%), lack of internet access (34.5%) and limited time (31.9%). High interest in DCBL was reported by 47.4%, and 41.7% chose the midpoint. High interest was independently associated with higher confidence (adjusted odds ratio [aOR] 1.51, 95% CI 1.26–1.81) and higher engagement with current teaching (aOR 1.54, 1.29–1.83). It was less likely with lack of internet access (aOR 0.56, 0.41–0.76) and prior learning with digital cases (aOR 0.71, 0.53–0.95). Students valued realism, interactivity, visuals and anytime access, and most wanted cases on communicable diseases, outbreak investigation and maternal and child health. Conclusions Interest in DCBL was moderate rather than enthusiastic. It followed students’ engagement and confidence rather than prior exposure. DCBL modules for Community Medicine should be realistic, decision-focused and interactive, work on mobile devices and low-bandwidth connections, and be linked to field and classroom teaching. Their design should specifically reach disengaged and less confident learners.