{"title":"Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis.","authors":"Yunlu Xiang, Dong Liu, Liang Liu, I-Chun Liu, Lanka Wu, Hao Fan","doi":"10.3389/fmed.2025.1452051","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Case-based learning (CBL) is recognized for its potential to enhance critical thinking in nursing education. This meta-analysis aimed to assess the impact of CBL alone or in combination with other methods on improving critical thinking dispositions among nursing students in China.</p><p><strong>Methods: </strong>A systematic search was conducted in databases including PubMed, Embase, Cochrane Library, CINAHL and China National Knowledge Infrastructure from inception of the databases through June 1, 2024. Studies that utilized the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV) and compared CBL with traditional teaching methods were included. Random-effects models were used to pool the mean differences (MD) in critical thinking scores, and subgroup analyses were performed based on participant types and intervention methods.</p><p><strong>Results: </strong>Thirteen studies involving 1,396 participants were included. The pooled results indicated a significant improvement in critical thinking dispositions (MD = 26.39, 95% CI: 18.71 to 34.06). Subgroup analysis revealed that nursing interns and combinations of CBL with problem-based learning (PBL) reported higher improvements. Secondary outcomes showed significant gains in both theoretical knowledge and operational skills, with heterogeneity observed across studies (<i>I</i> <sup>2</sup> > 79%). The Egger's test (<i>p</i> = 0.95) suggested no significant publication bias.</p><p><strong>Conclusion: </strong>CBL significantly enhances critical thinking among nursing students in China, particularly when integrated with PBL. Despite the observed heterogeneity, the findings support the incorporation of CBL into nursing curricula to foster critical analytical skills. Further research should explore the contextual factors that affect the variability in outcomes.</p>","PeriodicalId":12488,"journal":{"name":"Frontiers in Medicine","volume":"12 ","pages":"1452051"},"PeriodicalIF":3.1000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956162/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fmed.2025.1452051","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Case-based learning (CBL) is recognized for its potential to enhance critical thinking in nursing education. This meta-analysis aimed to assess the impact of CBL alone or in combination with other methods on improving critical thinking dispositions among nursing students in China.
Methods: A systematic search was conducted in databases including PubMed, Embase, Cochrane Library, CINAHL and China National Knowledge Infrastructure from inception of the databases through June 1, 2024. Studies that utilized the Chinese Version of Critical Thinking Dispositions Inventory (CTDI-CV) and compared CBL with traditional teaching methods were included. Random-effects models were used to pool the mean differences (MD) in critical thinking scores, and subgroup analyses were performed based on participant types and intervention methods.
Results: Thirteen studies involving 1,396 participants were included. The pooled results indicated a significant improvement in critical thinking dispositions (MD = 26.39, 95% CI: 18.71 to 34.06). Subgroup analysis revealed that nursing interns and combinations of CBL with problem-based learning (PBL) reported higher improvements. Secondary outcomes showed significant gains in both theoretical knowledge and operational skills, with heterogeneity observed across studies (I2 > 79%). The Egger's test (p = 0.95) suggested no significant publication bias.
Conclusion: CBL significantly enhances critical thinking among nursing students in China, particularly when integrated with PBL. Despite the observed heterogeneity, the findings support the incorporation of CBL into nursing curricula to foster critical analytical skills. Further research should explore the contextual factors that affect the variability in outcomes.
期刊介绍:
Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate
- the use of patient-reported outcomes under real world conditions
- the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines
- the scientific bases for guidelines and decisions from regulatory authorities
- access to medicinal products and medical devices worldwide
- addressing the grand health challenges around the world