What question did this study set out to answer?

To evaluate the effectiveness of combining the Plan-Do-Check-Act (PDCA) cycle with case-based learning (CBL) in clinical hematology education.

August 19, 2026BMC Medical Education0 citationsOpen Access

Enhancing clinical teaching in hematology: a retrospective study on the integration of the PDCA cycle with case-based learning

LLLiangliang Li HLHuan Liu TCTingyong Cao

Key Points

To evaluate the effectiveness of combining the Plan-Do-Check-Act (PDCA) cycle with case-based learning (CBL) in clinical hematology education.
Retrospective cohort study of 60 clinical medical students undergoing a hematology internship at the Second Hospital of Lanzhou University (July 2024 to July 2025).
Compared traditional teaching (control group, n = 30) with an iterative PDCA-CBL model (experimental group, n = 30) using multiple myeloma cases across four weekly cycles of increasing complexity.
Evaluated performance via weekly formative assessments, end-of-internship summative exams across four competency domains, and student satisfaction surveys.
The experimental group significantly outperformed the control group in theoretical knowledge (88.27 ± 6.48 vs 83.03 ± 6.52), case analysis (91.17 ± 4.75 vs 81.87 ± 5.77), and comprehensive performance (86.17 ± 6.80 vs 78.83 ± 5.79; P < 0.05 for all).
No statistically significant difference between experimental and control groups was observed in clinical skills (87.23 ± 5.84 vs 84.10 ± 7.52; P > 0.05).
Experimental group scores showed significant upward trends across sequential cycles for cognitive domains (P < 0.0001) and clinical skills (F = 3.92, P < 0.05), alongside significantly higher overall satisfaction (P < 0.05).

Abstract

To investigate the impact of integrating the Plan-Do-Check-Act (PDCA) cycle with the case-based learning (CBL) model in clinical practice teaching in Hematology. This retrospective cohort study included sixty clinical medical students who completed their internship in the Department of Hematology at the Second Hospital of Lanzhou University from July 2024 to July 2025. Students were assigned to either the control group (traditional teaching, n = 30) or the experimental group (PDCA-CBL model, n = 30) based on their internship batch. Multiple myeloma (MM) was used as the teaching case for both groups. In the experimental group, the 4-week internship was structured to implement four successive PDCA cycles, with each cycle lasting one week and featuring progressively increasing case complexity. All students participated in every cycle, with formative assessments conducted at the end of each cycle. At the end of the overall internship, both groups completed a summative examination and a teaching satisfaction survey. The experimental group significantly outperformed the control group in theoretical knowledge (88.27 ± 6.48 vs 83.03 ± 6.52), case analysis (91.17 ± 4.75 vs 81.87 ± 5.77), and comprehensive performance (86.17 ± 6.80 vs 78.83 ± 5.79) ( P 0.05). Within the experimental group, as the PDCA cycles progressed sequentially, theoretical knowledge, case analysis and overall performance demonstrated significant upward trends ( P < 0.0001 for all). Although the overall comparison of skills across the four cycles reached statistical significance (F = 3.92, P < 0.05), the effect size was smaller than that observed for cognitive domains. Additionally, the experimental group reported significantly higher teaching satisfaction compared to the control group ( P < 0.05). The PDCA-CBL teaching model significantly enhances students' theoretical knowledge, clinical reasoning, and comprehensive abilities through continuous iterative improvement, thereby improving the effectiveness of clinical teaching in the department of hematology.

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