Background: The 'Problem-based learning' (PBL) teaching mode has been widely used in various disciplines of medical education. Evidence-based medicine (EBM) is a course concerning methodology and being more and more popular in medical students in China.
Objectives:This study aims to systematically retrieve and synthesise existing research evidence to investigate the effect and the students’ satisfactory of applying PBL in teaching EBM compared to Lecture-based learning (LBL).
Methods:Five electronic databases were searched to include randomised-controlled trials (RCT) which compared the effect of PBL and LBL method in teaching EBM, methodological quality of included trials was assessed using the Cochrane risk-of-bias assessment method. Revman 5.3 software was used for data analyses. Risk ratio (RR) with a 95% confidence interval (CI) and mean difference (MD) with a 95% CI were used as effect measure. Meta-analysis was to be used if sufficient trials without obvious clinical or statistical heterogeneity were available.
Results: Six RCTs with potential high risk of performance bias were included. Three trials showed significant improvement of examination scores after PBL teaching compared to LBL (MD varied from 9.14 to 20.20), and one trial reported the opposite results (MD=-2.00, 95%CI -3.98 to -0.02, 155 students), due to the obvious statistical heterogeneity (I2=98%), meta-analysis could not be done for this outcome (Figure 1).Regarding to students’ satisfactory for the teaching effect, meta-analysis with three trials (involved 285 students) showed PBL may help to stimulate interest in learning (RR=1.37, 95%CI 1.07-1.74, I2=68%), improve language skills (RR=1.37, 95%CI 1.16-1.62, I2=0%), ability to obtain information (RR=1.31, 95%CI 1.07-1.60, I2=56%) and analytical skills to solve problems (RR=1.32, 95%CI 1.03-1.69, I2=55%), etc.(Figure 2)
Conclusions: According to our findings, currently low-quality evidence showed PBL may be more appropriate to be used in teaching EBM to help medical students acquiring the research skills and applying the EBM knowledge in clinical practice.