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Effects of CBL-based online-offline blended teaching on the course of clinical reasoning in general practice
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DOI：10.1186/s12909-026-09961-7.png)
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Abstract
En 中文
As a core course advocating General Practice Competency Education (GPCE) in applied medical colleges, Clinical Reasoning in General Practice directly shapes future professionals’ primary care competencies. Given the limitations of traditional instructional models, we integrated the Zhihuishu online platform and adopted a case-based learning (CBL) approach to implement an online-offline blended teaching model and evaluate its effectiveness. In this non-randomized cohort comparison, the CBL-based blended teaching group achieved significantly higher exam scores than the traditional instruction group, suggesting that the model may be associated with improved academic performance compared with the traditional approach, within this single institution context. Regardless of group, female students consistently outperformed male students across all assessment metrics. A cross-sectional survey of 401 students from the experimental group revealed that female students showed significantly higher behavioral engagement than male students, while significant differences in emotional engagement were observed across different majors. A significant positive non-linear relationship was found between learning behavior and final scores. Students with higher learning engagement were 15.95 times more likely to be willing to report willingness to work in grassroots settings compared to those with low engagement. These findings suggest that female students’ behavioral engagement and emotional engagement of major may significantly influence learning outcomes in blended learning environments. Higher learning engagement also correlates with a more positive attitude toward grassroots medical careers, but the limitations of cross-sectional surveys and potential confounding factors need to be considered.
Keywords:
College Students
Learning engagement
Blended learning environment
General practice education
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