Combined Case-Based and Problem-Based Learning in a Cardiothoracic ICU: A Retrospective Nonrandomized Comparative...

To compare immediate knowledge improvement, simulation performance, and participant satisfaction between combined case-based learning and problem-based learning (CBL-PBL) and traditional lecture-based training among cardiothoracic intensive care unit (ICU) professionals in a single-center retrospective nonrandomized comparative study.

This single-center retrospective nonrandomized comparative study reviewed training records for 46 healthcare professionals at Nanjing Drum Tower Hospital, China, from January to December 2024. Training-group membership was preference-based, with 23 participants per group. Outcomes included pre-to-post knowledge change, simulation performance, and satisfaction. Additional unadjusted comparisons used the Welch method. Exploratory logistic regression examined membership in a median-defined higher post-training score category, adjusting for age, sex, professional experience, and baseline knowledge. Clinical indicators were reported descriptively.

The between-group difference in knowledge improvement favored CBL-PBL by 7.60 points (approximate 95% CI 1.01-14.19; P = 0.025). Simulation-score differences favored CBL-PBL across three scenarios, ranging from 1.60 to 1.90 points (all P ≤ 0.001). Satisfaction was higher by 2.80 points (95% CI 1.91-3.69; P < 0.001). CBL-PBL was associated with higher odds of membership in the higher-score category (adjusted OR 8.961; 95% CI 1.861-43.156; P = 0.006), although the estimate was imprecise.

Structured case discussion and collaborative problem-solving warrant further evaluation as components of cardiothoracic ICU training. Prospective studies with validated assessments and delayed follow-up are needed before recommending routine adoption or claiming sustained learning or patient benefit.