Case-based CDIO learning and decision-making performance in undergraduate health sciences education

Introduction Innovative teaching approaches are increasingly adopted in health sciences education to support the development of students' decision-making skills. However, evidence regarding the effectiveness of case-based CDIO learning and the role of learner-related factors associated with performance remains limited. This study examined changes in students' decision-making performance following the implementation of case-based CDIO learning and explored the associations of safety awareness and self-confidence with post-intervention performance. Materials and methods A quasi-experimental pre–post study was conducted with 89 undergraduate students enrolled in a health-related course. Decision-making performance was assessed before and after the intervention using a rubric-based evaluation. Safety awareness and self-confidence were measured using self-report questionnaires. A paired t-test was used to examine changes in performance, and multiple linear regression analysis was conducted to assess the associations of safety awareness and self-confidence with post-intervention decision-making performance while controlling for baseline performance. Results Decision-making scores increased significantly following the intervention ( t (88) = 8.31, p < 0.001). The regression model was statistically significant ( F (3, 85) = 15.04, p < 0.001), explaining 34.7% of the variance in post-intervention decision-making performance ( R 2 = 0.347). Baseline performance ( β = 0.41, p < 0.001) and self-confidence ( β = 0.29, p = 0.004) were significant positive predictors, whereas safety awareness was not significantly associated with performance ( p = 0.840). Conclusion Case-based CDIO learning appears to be a promising instructional approach for supporting the development of students' decision-making performance. Self-confidence was identified as a significant factor associated with performance after controlling for baseline performance, suggesting that learner perceptions may influence how effectively students apply knowledge in practice-oriented contexts.