Literature review and meta-analysis of problem-based learning in nursing students

Purpose: The objective of this systematic review and meta-analysis was to estimate the effectiveness of problem-based learning in developing student nurses’ critical thinking, problem solving, and self-directed learning. Methods: To conduct the meta-analysis, 1,963 studies were retrieved from eight databases (Pubmed, EMbase, CINAHL, Cochrane Library, KERIS, KISS, NDSL, KoreaMed) without restriction on publication year. Articles published up to March 2019 were selected for this study. Fourteen studies were selected for meta-analysis based on satisfaction of inclusion criteria and low risk of bias. Baseline demographic data, exercise features, and outcome data were extracted from all trials included. The data was analyzed using the RevMan 5.3 program. Results: Most studies were of low risk of bias. The pooled effect size showed problem-based learning was able to improve nursing students’ critical thinking (ES=0.29, 95% Cl=0.04~0.54, p=.002), problem solving (ES=0.39, 95% Cl=-0.09~0.87, p=.11), and self-directed learning (ES=0.35, 95% Cl=-0.22~0.91, p=.23) compared with traditional lectures. Conclusion: PBL help improve the critical thinking in nursing students. Although problem solving and self directed learning were not affected, more research with a larger sample size and repeated meta-analysis of PBL are required.