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. 2025 Apr 8:12:1522830.
doi: 10.3389/fmed.2025.1522830. eCollection 2025.

Effectiveness of Gagné's 9 Events of Instruction in health professions education: a systematic review and meta-analysis

Yue Li  1 , Zhengjv Liang  2 , Zhongyan Li  3 , Yuhuan Yu  4 , Qing Yang  2 , Xiao Li  1
Affiliations

Effectiveness of Gagné's 9 Events of Instruction in health professions education: a systematic review and meta-analysis

Yue Li et al. Front Med (Lausanne). .

Abstract

Objective: This review assesses the effectiveness of Gagné's 9 Events of Instruction in improving theoretical scores and clinical practice abilities in medical education.

Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two researchers conducted a comprehensive search of Chinese and English electronic databases (Web of Science, PubMed, Embase, Cochrane Library, CNKI, VIP, Wanfang). The participants included clinical medical students, nursing students, specialized medical students, and medical interns, among others related to healthcare. Educators used Gagné's 9 Events of Instruction to guide these populations in theoretical learning and/or daily clinical practice. The search was conducted from the inception of the databases to February 27, 2025. Two researchers independently identified, selected, and extracted data from the studies, assessed the quality using the Cochrane Risk of Bias tool, and performed meta-analyses using RevMan 5.4 and Stata 17.0.

Results: A total of 11 studies involving 825 participants were included in the meta-analysis, including 5 RCTs and 6 CSs. In the cumulative meta-analysis, compared with the traditional LBL model, Gagné's 9 Events of Instruction significantly improved learners' KES (SMD 1.55, 95% CI: 0.81 to 2.29; p < 0.00001), PS (SMD 1.83, 95% CI: 1.19 to 2.47; p < 0.00001), LC (OR 4.92, 95% CI: 3.13 to 7.73; p < 0.0001), and TS (OR 7.86, 95% CI: 3.22 to 19.20; p < 0.0001).

Conclusion: The meta-analysis indicated that, compared to traditional medical teaching models, Gagné's 9 Events of Instruction are significantly effective in health professions education and can effectively enhance learners' KES, PS, LC, and TS.

Keywords: Gagné’s 9 Events of Instruction; Gagné’s instructional theory; clinical medicine; health professions education; medical students; meta-analysis; nursing education; traditional teaching.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the search strategy.
Figure 2
Figure 2
Resultsofriskbiasassessment.
Figure 3
Figure 3
Forest plot of KES for cognitive learning theory compared with LBL.
Figure 4
Figure 4
Forest plot of PS for cognitive learning theory compared with LBL.
Figure 5
Figure 5
Forest plot of LC for cognitive learning theory compared with LBL.
Figure 6
Figure 6
Forest plot of TS for cognitive learning theory compared with LBL.
Figure 7
Figure 7
Publication bias of KES.
Figure 8
Figure 8
Sensitive analysis of KES.
See this image and copyright information in PMC

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