An Active Three-in-One Teaching Approach Integrating Article Analysis, SPSS Simulation, and Lectures in Biostatistics Education for Medical Students

INTRODUCTION: Medical students recognized the usefulness of biostatistics in clinical practice but also perceived it as a complex, impractical subject. This study evaluated the effect of the three-in-one (3-in-1) active teaching method on academic performance in biostatistics, as well as on student satisfaction and perceived understanding, among second- and ninth-semester medical students using a comparative educational design stratified by academic level. METHODOLOGY: An observational, prospective, post-educational intervention study was conducted with stratification by academic level (second and ninth semesters). Random assignment within each stratum was performed using SPSS version 29 (IBM Corp., Armonk, NY). The study population consisted of students enrolled in the medical program at the Regional Autonomous University of the Andes during the 2025 academic year. Students who attended at least 80% of the sessions and provided informed consent were included; those who could not participate due to limitations or withdrew their consent were excluded. The sample was divided into two groups: an intervention group that received the "3-in-1" active method (article analysis, SPSS simulation, and lecture) and a control group that continued with the traditional methodology. Academic performance was measured using an 11-question multiple-choice test (Médico Interno Residente, MIR), while attitudes, mastery, and satisfaction were assessed using a Likert scale. The statistical analysis included descriptive statistics, Student's t-test, Mann-Whitney U test, and chi-square test, all with a significance level of p < 0.05. Results: The sociodemographic characteristics of the groups were comparable, with no significant differences in gender, cohabitation status, ethnicity, geographical origin, or academic history. Only age differed between the groups (p = 0.016). Regarding academic performance, the intervention group had a mean score of 13.13, while the control group had a mean score of 10.92, a statistically significant difference (t = -2.346; p = 0.023). Satisfaction with the teaching method was significantly higher in the intervention group (U = 379.5; p = 0.016). Likewise, the "3-in-1" group had a higher perceived mastery of the content (7.74 vs. 5.58; p < 0.001). There were no significant differences in the comparison by academic semester (p = 0.511), suggesting that the level of training did not influence the scores obtained. CONCLUSION: Compared to the traditional methodology, the active "3-in-1" methodology was associated with higher academic performance, greater student satisfaction, and a better perception of content mastery. These results suggest the importance of using active and applied pedagogical strategies when teaching biostatistics to medical students.