From blocks to learning: Development and content validity of a Minecraft-based rural simulation for occupational therapy training

Background. Rural occupational therapy practice in South Africa (SA) demands context-specific skills, yet training lacks authentic simulations. Digital game-based learning using Minecraft Education Edition may address this gap by integrating the Technological Pedagogical Content Knowledge framework, the Analyse–Design–Develop–Implement–Evaluate model and the Community of Inquiry framework to develop competency-aligned simulations.Objectives. To design, develop and validate a Minecraft-based rural simulation for occupational therapy training using design-based research principles.Methods. Design-based research with iterative microcycles guided development at a SA university. Six respondents (three occupational therapy experts and three digital education experts) were purposively sampled. Content Validity Index (CVI) was used to assess alignment with occupational therapy competencies using 4-point Likert-scale surveys. Data analysis included item-level (I-CVI ≥0.83) and scale-level (S-CVI/Ave ≥0.90) validity thresholds.Results. Primary outcomes showed excellent content validity, with an overall S-CVI/Ave of 0.95 and all items achieving I-CVI of ≥0.83. Domain scores ranged from 78.2% (environmental navigation) to 81.4% (water collection). Gamification elements enhanced engagement and authenticity.Conclusion. The Minecraft-based rural simulation demonstrated strong content validity for occupational therapy training. Recommendations include longitudinal efficacy testing with students and scalability to other rural health professions contexts