Research Article
Case-based Learning in Clinical Teaching Between China and Western Countries: A Systematic Review and
Meta-analysis
Issue:
Volume 14, Issue 2, April 2026
Pages:
20-33
Received:
6 March 2026
Accepted:
2 April 2026
Published:
21 April 2026
DOI:
10.11648/j.ajcem.20261402.11
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Abstract: Background: Case-based learning (CBL) has been widely adopted in clinical medical education across both Chinese and Western contexts. However, systematic and critical comparisons of CBL with lecture-based learning (LBL) and other emerging pedagogical approaches remain limited, particularly given the cultural differences between these regions. Thus, this study aimed to investigate variations in the effectiveness of CBL implementation in clinical medical education across different cultural contexts through a systematic review. Methods: The search period spanned from the inception of each database to December 2024, covering PubMed, Embase, Web of Science, CNKI, VIP, and Wanfang databases. This study incorporated CBL teaching effectiveness data from medical students and clinical education research subjects in Chinese and Western countries, with comparative analyses conducted against LBL and other innovative pedagogical approaches. The primary outcome measures included objective theoretical assessment scores and clinical practice skill evaluations, while secondary outcome measures consisted of learner satisfaction ratings obtained through standardized questionnaires. The meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (version 6.3) and adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: Following systematic screening, 14 eligible studies involving 1,696 participants were ultimately included. The analysis revealed that compared to LBL, CBL demonstrated a statistically significant improvement in both theoretical assessment scores (SMD = 0.30, 95% CI [-0.09, 0.70]) and clinical practice performance (P < 0.001) among students. Furthermore, CBL demonstrated significant improvements in students' self-directed learning capability (SMD = 1.78, 95% CI [1.46, 2.11], large effect size), clinical analytical skills, and critical thinking abilities (all p < 0.001). Conclusions: CBL demonstrated positive effects in both Chinese and Western educational systems, as evidenced by the improved objective academic performance and increased learner satisfaction. Moreover, CBL exhibited marked consistency in its implementation outcomes across clinical education systems in different countries. Overall, it can be regarded as an effective approach for enhancing students' objective assessment scores and learning engagement.
Abstract: Background: Case-based learning (CBL) has been widely adopted in clinical medical education across both Chinese and Western contexts. However, systematic and critical comparisons of CBL with lecture-based learning (LBL) and other emerging pedagogical approaches remain limited, particularly given the cultural differences between these regions. Thus,...
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,
Ziyan Cao
