Problem-based or lecture-based learning, old topic in the new field: a meta-analysis on the effects of PBL teaching...

Standardized residency training (SRT) is crucial for graduate medical education and the training of high-quality doctors. Nevertheless, China started SRT nationwide only in the recent decade. During these years, researchers have been searching for suitable teaching methods to improve the abilities of residents. Although the problem-based learning (PBL) teaching mode has been applied in undergraduate teaching for many years, the teaching effect of PBL has not been unified in Chinese SRT according to the core competences of the residents.

Studies that compared the teaching effect of PBL and lecture-based learning (LBL) on SRT in China from January 2010 to April 2020 in the Chinese databases, such as China National Knowledge Infrastructure (CNKI), WanFang, WeiPu, Chinese BioMedical Literature (CBM), and English-language online databases, such as PubMed, Embase, and Cochrane Library were systematically reviewed. Data were analyzed using the Stata version 12.0 software.

A total of 75 articles (76 studies) were included in this meta-analysis. Compared with LBL group, PBL-based methods are more effective in the mastery of medical theory knowledge (WMD = 7.14, 95% CI: 5.93-8.34), operational skills (WMD = 6.54, 95% CI: 4.55-8.53), analysis and diagnosis of cases (WMD = 8.52, 95% CI: 7.50-9.53), and overall capacity (WMD = 8.70, 95% CI: 6.87-10.53), but showed no advantage on operational skills in diagnostic imaging (WMD = 1.30, 95% CI: -0.11-2.71). The questionnaire surveys analyzed in this meta-analysis indicated the positive effects of PBL on the mastery of theoretical knowledge, clinical diagnostic thinking, teamwork ability, ability to analyze and solve problems, ability to consult documents, learning interest and learning efficiency, but that there were no advantages in improving self-directed learning ability, communication ability and hands-on ability. The questionnaire result analyzed in this meta-analysis also showed the residents' satisfaction with PBL-based strategies.

Taken together, the current meta-analysis provides a systematic and comprehensive analysis on PBL teaching mode in Chinese SRT and outlines a path for further research on the detailed design of suitable teaching methods for different specialties and abilities.