Impact of different teaching modes on medical students’ performance under the scoring criteria for multiple-choice questions: A meta-analysis

BACKGROUND: Comparing the impact of different educational modes on medical students' performance under the scoring criteria for multiple-choice questions, would provide a basis for selecting more appropriate and effective teaching modes for talent development. METHODS: We searched databases such as CNKI, Wanfang, PubMed, and Web of Science to collect publications on the comparison of medical students' performance under the scoring criteria for multiple-choice questions and different teaching modes, with a focus on studies conducted between 2015 and 2024. Chinese search terms included multiple-choice questions, multiple-choice exam, medical students, flipped classroom, simulation teaching, team-based learning, and blended teaching. Equivalent English search terms were "multiple-choice questions," "multiple-choice exam," "medical student," "flipped classroom," "simulation teaching," "team-based learning," and "blended teaching." Two researchers independently conducted publications screening, data extraction, and quality assessment, and performed meta-analysis using R 4.3.0 software. RESULTS: This study included a total of 24 publications, among them 6 on flipped classroom teaching, 13 on simulation teaching, 2 on team-based learning, and 3 on blended teaching, covering 13 countries and involving 2086 participants in the experimental group and 2113 participants in the control group. Using scores from multiple-choice questions as the criterion, flipped classroom teaching and simulation teaching demonstrated significantly higher scores compared to traditional teaching, with standard mean differences (MDs) of 0.39 (95% CI: 0.14-0.65) and 0.33 (95% CI: 0.18-0.48), respectively. However, team-based learning and blended teaching showed no significant differences in scores compared to traditional teaching, with standard MDs of 0.48 (95% CI: -0.36 to 1.31) and -0.63 (95% CI: -1.85 to 0.59), respectively. CONCLUSION: Compared to traditional teaching, flipped classroom teaching and simulation teaching were more beneficial for students' performance. It is recommended to continue implementing high-quality flipped classroom teaching and simulation teaching to address the challenges in medical education reform.