After the theoretical training given to the students, pre-tests will be administered, followed by post-tests two weeks later. Subsequently, the responsible researcher will discuss the case with the control group and collect feedback from the students.

The game link will be shared with the control group.

The case of an anxious patient will be turned into a game using an interactive web-based tool (https://www.powtoon.com/) (Powtoon platform) that resembles real life. The program will feature a voice-over tool and various characters. In the game, students will be asked to identify cognitive distortions and determine communication techniques through questions created for the anxious individual. A QR code will be generated from the prepared game link. After theoretical training, pre-tests will be administered, then the QR code will be projected onto the main screen in the classroom by the researcher in charge. Students will be given access using the QR code and will be asked to play the game. They will be given the opportunity to play the game at least twice over a two-week period. One week after playing the game, the Cognitive Distortion Scale and Interpersonal Communication Competence scales will be completed.

The case of an anxious patient admitted to the hospital was prepared by researchers in accordance with the literature. The prepared case was created based on the use of a game-based learning method for students in the intervention group. The case prepared in line with the literature and the questions related to the case were sent to three experts for evaluation. Revisions were made to the case based on the experts' recommendations, and the final version was produced.The responsible researcher will provide intervention and control group students with refresher theoretical training. After the theoretical training, students will be given a sociodemographic information form. Then, all students will be given a cognitive distortion and interpersonal communication competency scale (pre-test). Students in the intervention group will be given the the opportunity to play the game at least twice over a two-week period.One week after playing the game, post test will be conducted.

Cognitive Distortion Scale: This self-report scale was developed by Briere (2000). Batmaz et al. (2015) adapted the scale into Turkish. It consists of 15 questions related to cognitive distortions. Thinking in extremes, fortune telling (catastrophizing), discounting the positive, emotional reasoning, labeling, magnifying/minimizing, selective abstraction, mind reading, overgeneralization, personalization, impositions, jumping to conclusions, blaming oneself or others, what if? Thinking in extremes, and unfair comparison are assessed as cognitive distortions. Three different scores can be obtained from the scale: (i) frequency score, (ii) intensity score, and (iii) total score. The total (possible range = 0-75) is obtained by summing the scores of each item on the scale (Batmaz et al. 2015).

Interpersonal Communication Competence Scale: The measurement tool developed by Huang and Lin (2018) was adapted into Turkish by Çıkrıkçı and Çinpolat (2021). The 15-item inventory is rated on a 5-point Likert. The inventory has 4 subscales. These subscales are listening skills, social comfort skills, empathy and expression skills.In the scoring, 2 items (items 10 and 13) are reverse-scored. The scores that can be obtained from the measurement tool range from 15 to 75 (Çıkrıkçı & Çinpolat 2021).

Sociodemographic Information Form: Prepared by researchers in line with the literature. It consists of questions such as age, gender, place of residence, family type, and income status.