Which novel teaching strategy is most recommended in medical education? A systematic review and network meta-analysis

Abstract

Aim: There is no conclusive evidence which one is the optimal methodology for enhancing the quality and efficacy of learning for medical students. Therefore, this systematic review and network meta-analysis aims to evaluate and prioritize various teaching strategies in medical education, including simulation-based learning (SBL), flipped classrooms (FC), problem-based learning (PBL), team-based learning (TBL), case-based learning (CBL), and bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary (BOPPPS).

Methods: We conducted a comprehensive systematic search of PubMed, Embase, Web of Science, the Cochrane Library, and some key medical education journals up to November 31, 2023. The following keywords were searched in MeSH: ("medical students") AND ("problem-based learning" OR "problem solving") AND ("Randomized Controlled Trials as Topic"). Two authors independently carried out data extraction and quality assessment from the final selection of records following a full-text assessment based on strict eligibility criteria. Pairwise and network meta-analyses were then applied to calculate pooled standardized mean differences (SMDs) and 95% confidence intervals (95%CIs) using a random-effects model. Statistical analysis was performed by R software (4.3.1) and Stata 14 software.

Results: A total of 80 randomized controlled trials with 6,180 students were included in the study. Compared to LBL, CBL (SMD = 1.19; 95% CI 0.49-1.90; p < 0.05; SUCRA = 89.4%), PBL (SMD = 3.37; 95% CI 1.23-5.51; p < 0.05; SUCRA = 93.3%), and SBL (SMD = 2.64; 95% CI 1.28-4.00; p < 0.05; SUCRA = 96.2%) were identified as the most effective methods in enhancing theoretical test scores, experimental or practical test scores, and students' satisfaction scores, respectively. Furthermore, subgroup analysis indicated that CBL (SUCRA = 97.7%) and PBL (SUCRA = 60.3%) were the most effective method for enhancing learning effectiveness within clinical curricula.

Conclusions: Among the six novel teaching strategies evaluated, CBL and PBL are more effective in enhancing the quality and efficacy of learning for medical students; SBL was determined to offer a superior learning experience throughout the educational process. However, this analysis revealed only minor differences among those novel teaching strategies.

Keywords: Learning; Medical Education; Medical Students; Network Meta-Analysis; Systematic Reviews; Teaching.