Effectiveness of student-centered active learning models versus lecture-based learning in Chinese medical education: a systematic review and meta-analysis of Chinese database–indexed randomized trials

Background This Chinese database–based systematic review and meta-analysis evaluated the effectiveness of student-centered active learning models, including problem-based learning (PBL), case-based learning (CBL), team-based learning (TBL), and their combinations, compared with lecture-based learning (LBL) in medical education. Methods A systematic review of 38 randomized controlled trials indexed in major Chinese databases was conducted. The literature search was performed in China National Knowledge Infrastructure, Wanfang Database, and VIP Database. PubMed, Web of Science, Embase, ERIC, Scopus, and other international biomedical or education databases were not searched. Meta-analyses were performed for eligible outcomes. Because of high initial heterogeneity, outcome score data were transformed into binary variables for the main pooled analyses, and odds ratios were used as the unified effect size. Results Student-centered active learning models were associated with better outcomes in overall academic performance, theoretical knowledge, case analysis, skill operation, and several competency-related domains compared with LBL. After data transformation, scale-related heterogeneity was reduced in the main dichotomized analyses. However, the certainty of evidence was generally low or very low, mainly because of methodological limitations, the Chinese database–only evidence base, data-transformation procedures, imprecision in some outcomes, and possible publication bias or small-study effects. No significant difference was observed for medical record writing. Conclusion This Chinese database–based meta-analysis suggests that student-centered active learning models, including PBL, CBL, TBL, and their combinations, may offer potential benefits over LBL in improving knowledge acquisition, clinical skills, and broader competencies of medical students. However, because the certainty of evidence was generally low or very low, and because the evidence was derived from studies indexed in Chinese databases, these findings should be interpreted cautiously and should not be directly generalized to all international medical education settings. Further high-quality, prospectively registered, and internationally representative studies are needed.