Li Ting, Hu Yidan, Song Ruohong, Liu Hangyu, Gao Xin, Wang Fei, Xiao Chengwei, Liu Xilin
Department of Orthopedics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Department of Orthopedics, No.1 Orthopedics Hospital Of Chengdu, Chengdu, 610031, China.
BMC Med Educ. 2025 Jan 13;25(1):60. doi: 10.1186/s12909-025-06654-5.
Three-dimensional (3D) visualization has become increasingly prevalent in orthopedic education to tackle the distinct anatomical challenges of the field. However, there is a conspicuous lack of systematic reviews that thoroughly evaluate both the advantages and drawbacks of integrating 3D with problem-based learning (3D + PBL).
A rigorous search of English databases (Cochrane Library, Embase, PubMed, Scopus, and Web of Science) and Chinese databases (National Knowledge Infrastructure: CNKI, Chongqing VIP: VIP, and Wan Fang) were performed up to July 2024 to identify relevant studies. Relevant studies were selected based on established eligibility criteria, with clinical data carefully extracted for analysis. Eighteen randomized controlled trials involving a total of 1,077 participants were included in the analysis.
The findings indicated that 3D + PBL instruction significantly outperformed traditional lecture-based learning (LBL) in terms of theoretical knowledge (SMD = 1.62, 95% CI: 1.14-2.10, P < 0.00001) and practical operational scores (SMD = 2.29, 95% CI: 1.41-3.16, P < 0.00001). Furthermore, students exposed to 3D + PBL teaching exhibited a significantly better understanding of orthopedic anatomical structures compared to those receiving LBL (SMD = 1.18, 95% CI: 0.71-1.65, P < 0.00001). Additionally, students in the 3D + PBL group achieved higher theoretical grades (OR = 2.95, 95% CI: 1.57-5.55, P = 0.0008) and reported greater overall satisfaction (OR = 3.26, 95% CI: 1.91-5.54, P < 0.0001) compared to their LBL counterparts.
Given the unique demands of orthopedic education, 3D + PBL emerges as a highly effective teaching method. It not only improves students' theoretical scores but also enhances their communication skills and comprehension of complex concepts. Furthermore, students exhibit greater satisfaction with this approach.
三维（3D）可视化在骨科教育中越来越普遍，以应对该领域独特的解剖学挑战。然而，明显缺乏全面评估3D与基于问题的学习（3D + PBL）相结合的优缺点的系统评价。
截至2024年7月，对英文数据库（Cochrane图书馆、Embase、PubMed、Scopus和科学网）和中文数据库（中国知网：CNKI、重庆维普：VIP和万方）进行了严格检索，以识别相关研究。根据既定的纳入标准选择相关研究，并仔细提取临床数据进行分析。分析纳入了18项随机对照试验，共涉及1077名参与者。
研究结果表明，在理论知识方面（标准化均数差[SMD]=1.62，95%置信区间[CI]：1.14 - 2.10，P < 0.00001）和实践操作得分方面（SMD = 2.29，95% CI：1.41 - 3.16，P < 0.00001），3D + PBL教学明显优于传统的基于讲座的学习（LBL）。此外，与接受LBL教学的学生相比，接受3D + PBL教学的学生对骨科解剖结构的理解明显更好（SMD = 1.18，95% CI：0.71 - 1.65，P < 0.00001）。此外，与LBL组的学生相比，3D + PBL组的学生获得了更高的理论成绩（比值比[OR]=2.95，95% CI：1.57 - 5.55，P = 0.0008），并报告了更高的总体满意度（OR = 3.26，95% CI：1.91 - 5.54，P < 0.0001）。
鉴于骨科教育的独特需求，3D + PBL成为一种高效的教学方法。它不仅提高了学生的理论成绩，还增强了他们的沟通能力和对复杂概念的理解。此外，学生对这种方法表现出更高的满意度。
