Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis

BackgroundCase-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.MethodsA...

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Main Authors: Yunlu Xiang, Dong Liu, Liang Liu, I-Chun Liu, Lanka Wu, Hao Fan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1452051/full
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author Yunlu Xiang
Dong Liu
Dong Liu
Dong Liu
Liang Liu
I-Chun Liu
Lanka Wu
Hao Fan
Hao Fan
Hao Fan
Hao Fan
author_facet Yunlu Xiang
Dong Liu
Dong Liu
Dong Liu
Liang Liu
I-Chun Liu
Lanka Wu
Hao Fan
Hao Fan
Hao Fan
Hao Fan
author_sort Yunlu Xiang
collection DOAJ
description BackgroundCase-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.MethodsA 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.ResultsThirteen 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.ConclusionCBL 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.
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spelling doaj-art-27ee4ba303e0499a8633dbff2b9cb1fb2025-08-20T02:55:56ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.14520511452051Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysisYunlu Xiang0Dong Liu1Dong Liu2Dong Liu3Liang Liu4I-Chun Liu5Lanka Wu6Hao Fan7Hao Fan8Hao Fan9Hao Fan10School of Teacher Development, Chongqing University of Education, Chongqing, ChinaSchool of Physical, Anshan Normal University, Anshan, ChinaCollege of Humanities and Social Sciences, Yuan Ze University, Taoyuan, TaiwanSchool of Tourism and Hotel Management, University of Sanya, Sanya, ChinaChengdu JinNiu GuoTou TianFu Industry Investment Co., Ltd, Chengdu, ChinaCollege of Humanities and Social Sciences, Yuan Ze University, Taoyuan, TaiwanSchool of Tourism and Hotel Management, University of Sanya, Sanya, ChinaSchool of Teacher Development, Chongqing University of Education, Chongqing, ChinaCollege of Humanities and Social Sciences, Yuan Ze University, Taoyuan, TaiwanSchool of Tourism and Hotel Management, University of Sanya, Sanya, ChinaSchool of Tourism and Service Management, Chongqing University of Education, Chongqing, ChinaBackgroundCase-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.MethodsA 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.ResultsThirteen 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.ConclusionCBL 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.https://www.frontiersin.org/articles/10.3389/fmed.2025.1452051/fullcase-based learningcritical thinkingnursing educationimpactmeta-analysis
spellingShingle Yunlu Xiang
Dong Liu
Dong Liu
Dong Liu
Liang Liu
I-Chun Liu
Lanka Wu
Hao Fan
Hao Fan
Hao Fan
Hao Fan
Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
Frontiers in Medicine
case-based learning
critical thinking
nursing education
impact
meta-analysis
title Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
title_full Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
title_fullStr Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
title_full_unstemmed Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
title_short Impact of case-based learning on critical thinking dispositions in Chinese nursing education: a systematic review and meta-analysis
title_sort impact of case based learning on critical thinking dispositions in chinese nursing education a systematic review and meta analysis
topic case-based learning
critical thinking
nursing education
impact
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1452051/full
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