The effectiveness of problem-based learning in orthopedics education: A systematic review and meta-analysis of randomized-controlled trials

Abstract

Abstract Background Currently, problem-based learning (PBL) has been widely used in many disciplines, but there is no systematic review exploring the advantages and disadvantages of PBL in orthopedic education. Objective We carried out a systematic review and meta-analysis to evaluate the effectiveness of PBL teaching for orthopedics education. Methods We searched PubMed, Cochrane library, Embase, Web of Science, Scopus, Chongqing VIP Database (VIP), Chinese National Knowledge Infrastructure (CNKI), and Wan Fang Database up to April 2023 for relevant studies. Relevant studies were identified by using specific eligibility criteria and data was extracted. Results A total of 51 randomized controlled trials with 4268 patients were included. Compared with traditional education, PBL teaching had higher theoretical score (SMD = 1.10, 95%Cl: 0.78 ~ 1.41, P < 0.00001), and the operational score and case analysis score in PBL teaching were significantly higher than traditional teaching (SMD = 2.07, 95%Cl: 1.61 ~ 2.53, P < 0.00001; SMD = 1.20, 95%Cl: 0.88 ~ 1.52, P < 0.00001). What’s more, the total score in PBL teaching was higher than that traditional teaching (MD = 5.69, 95%Cl: 5.11 ~ 6.26, P < 0.00001). And PBL teaching had higher teaching interest and teaching satisfaction than that traditional teaching (OR = 4.70, 95%Cl: 3.20 ~ 6.93, P < 0.00001; OR = 5.43, 95%Cl: 3.83 ~ 7.69, P < 0.00001). However, the learning time was less and learning pressure was higher in PBL teaching (OR = 0.12, 95%Cl: 0.06 ~ 0.24, P < 0.00001; OR = 5.95, 95%Cl: 3.16 ~ 11.23, P < 0.00001). Conclusion Current evidence indicated that PBL teaching can enhance the theoretical score, operational score, and case analysis score. And students had higher teaching interest and teaching satisfaction. But students can feel the higher study pressure and less study time. However, these findings needed to be verified in further by multi-center, double-blind and large sample RCTs.