Effectiveness of case-based learning combined with problem-based learning versus lecture-based learning in clinical medical education: a systematic review and meta-analysis

PURPOSE: This study employed meta-analysis to systematically assess the effects of case-based learning (CBL) combined with problem-based learning (PBL) teaching versus lecture-based learning (LBL) in clinical medical education, focusing on the comparison of knowledge acquisition, clinical skill development, and learning satisfaction, aiming to provide an evidence-based basis for medical education reform. METHODS: PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched to include randomized controlled trials comparing CBL combined with PBL instruction with LBL. Literature screening, data extraction, and quality assessment were conducted independently by two researchers, and meta-analysis was performed using RevMan 5.4 and Stata 17.0 software. RESULTS: A total of seven studies were included, covering a total of 604 participants. The meta-analysis revealed that CBL-PBL significantly improved students' theoretical examination scores [standardized mean difference (SMD) = 2.161, 95% confidence interval (CI): 1.215-3.106, P < .0001], practical skills scores (standardized mean difference = 1.594, 95% CI: 1.037-2.152, P < .0001), and learning satisfaction (pooled effect size = 0.860, 95% CI: 0.811-0.909, P < .0001), Furthermore, CBL-PBL showed significant advantages in enhancing clinical thinking skills (standardized mean difference = 3.661, 95% CI: 1.748-5.574, P < .0001). CONCLUSION: CBL-PBL is effective in enhancing clinical medical students' knowledge acquisition, clinical skills, and comprehensive competencies, and is superior to LBL. It is recommended that this teaching strategy be further promoted and optimized in clinical medical education to promote the comprehensive development of students' abilities.