整形外科教育における最も推奨される新しい教育戦略の特定：系統的レビューおよびネットワークメタアナリシス

Despite the growing adoption of novel teaching strategies in orthopaedics education, their comparative effectiveness remains unclear. This network meta-analysis (NMA) evaluates and ranks the efficacy of problem-based learning (PBL), virtual reality (VR), Video, three dimensions (3D) simulations, flipped classrooms (FC), 3D combined PBL, FC combined team based learning (TBL), and traditional lecture-based learning (LBL) in orthopaedic education.

A systematic search of PubMed, Web of Science, Embase, and Cochrane Library was conducted up to December 31, 2024. Randomized controlled trials (RCTs) comparing teaching strategies in orthopaedics education were included. Specific criteria were utilized to identify relevant studies, and data extraction was subsequently carried out. Outcomes included theoretical knowledge, procedural or clinical skills, and learner satisfaction. Pairwise and network meta-analyses were performed using R software.

After screening 893 studies, 11 RCTs involving 690 medical students or residents were included in the NMA. VR was more effective than LBL for procedural or clinical skills (SMD = 6.88, 95% CI: 1.05-12.13), while FC + TBL improved theoretical test scores with the highest SUCRA probability (81.73%). FC + TBL also enhanced student satisfaction (SMD = 1.42, 95% CI: 0.04-2.79), with PBL having the highest SUCRA probability (61.53%) for this outcome.

Our NMA found FC + TBL and VR to be the most effective novel teaching strategies in orthopaedics education for improving theoretical and clinical skill scores, respectively. However, differences among strategies were minor. Future studies with larger samples, diverse populations, and more outcome measures are needed for a comprehensive evaluation.