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. 2025 Oct 10;25(1):1401.
doi: 10.1186/s12909-025-07823-2.

Medical students' evaluation of digital problem-based learning: a mixed-methods systematic review

Camilla Rams Rathleff  1 , John Vergel  2 , Thomas Ryberg  3 , Jette Kolding Kristensen  4 , Patrik Kjaersdam Telléus  5
Affiliations

Medical students' evaluation of digital problem-based learning: a mixed-methods systematic review

Camilla Rams Rathleff et al. BMC Med Educ. .

Abstract

Background: Digital Problem-Based Learning (DPBL) is becoming more frequently used to facilitate the development of knowledge and skills in medical education, yet student satisfaction and engagement with DPBL remain insufficiently understood.

Methods: This mixed-methods systematic review aimed to examine how medical students perceive and experience DPBL. We searched four databases (Feb 5-Jun 30, 2024) following JBI and PRISMA guidelines, yielding 3459 abstracts and 56 included studies. Studies published at any time and in any language were considered. Two researchers independently conducted screening, selection, quality assessment and analysis. A segregated approach was used to synthesize the data. This method included a thematic synthesis of the qualitative data and a narrative review/meta-analysis for quantitative data where appropriate. The findings of both syntheses were then integrated and validated by stakeholders.

Results: The mixed-methods synthesis demonstrated that both quantitative and qualitative findings complemented each other, offering a comprehensive understanding of medical students' perceptions of DPBL. Overall, students had a positive evaluation of DPBL, despite some mixed perceptions. Quantitatively, the satisfaction rate was 78.51% (95% CI: 78.07% - 78.96%) across 20 studies. Qualitatively, students' social perceptions varied, with some feeling isolated and others valued the focused learning environment. DPBL tasks provided ownership, autonomy, and flexibility. Technology was useful, engaging, and motivational, though feedback was occasionally lacking. Visual and auditory features were appreciated, but tactile realism was limited. The study findings were validated by 10 medical students.

Conclusions: Our findings suggest that DPBL design still struggles to reconcile technological innovation with the social principles of traditional PBL. A hybrid model may offer a practical way to bridge this gap.

Keywords: Digital problem-based learning; Medical education; Student perspectives.

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Conflict of interest statement

Declarations. Authors’ information: Camilla Rams Rathleff (CRR): Camilla Rams Rathleff is a Ph.D. student at Aalborg University, Denmark. Her background for entering the Ph.D. position was an evolving curiosity in exploring the combination of her experience and competencies from the field of clinical education at Aalborg University Hospital and her master’s degree, in Clinical Science and Technology (2016). Her most recent position was as a clinical educator for physiotherapy students in an acute hospital setting. Her Ph.D. project will focus on facilitating collaborative competencies among medical students by technology. John Vergel (JV): John Vergel is an associate professor at Universidad del Rosario Medical School, Colombia. His research interests include Health Literacy and Narrative Inquiry in MedEd. His work examines medical students and teachers’ subjective experiences in the practice of curriculum integration reforms and how curriculum integration promotes students’ clinical reasoning. Thomas Ryberg (TR): Thomas Ryberg is Professor of Problem-Based Learning (PBL) and digital learning and director of Institute for Advanced Study in PBL (IAS PBL) at Aalborg University, Denmark. His primary research interests are within the fields of Networked Learning and PBL. In particular, he is interested in PBL and how new media and technologies transform our ways of thinking about and designing for networked and hybrid learning. He is co-chair of the International Networked Learning Conference (https://www.networkedlearning.aau.dk/) and co-editor of the Springer book series ‘Research in Networked Learning’. Jette Kolding Kristensen (JKK): Jette Kolding Kristensen is a clinical professor at the Department of Clinical Medicine, Aalborg University, Denmark. Throughout her career, Jette Kolding Kristensen has alternated between clinical appointments alongside a university career. Her research deals with the identification, monitoring and management of chronic diseases such as Type-2 diabetes and thyroid diseases. In addition, she works with quality development, development of clinical guidelines and registry research. For a number of years, she has been head of studies at the medicine program at a PBL university working with PBL in a case context. Cases where the students integrate theoretical knowledge with clinical thinking. In particular, she is interested in how new technologies interfere with students learning and interaction with patients, other students, and healthcare professionals. Patrik Kjærsdam Telléus (PKT): Patrik Kjærsdam Telléus is an associate professor at the Department of Health Science and Technology and at the Institute for Advanced Study in PBL (IAS PBL) at Aalborg University, Denmark. With a starting point in philosophy primarily analytical philosophy, he conducts research in subjects within medical ethics as well as medical and healthcare education, science, and profession. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Trial registration: February 7, 2024, the protocol was pre-registered at Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/RB5K9 ).

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. Illustrating records screened, excluded, and included for data extraction and synthesis (quantitative and qualitative)
Fig. 2
Fig. 2
Included publications mapped over time. In the figure, the x-axis shows the year of publication and the y-axis shows the number of publications
Fig. 3
Fig. 3
Forest plot of the student satisfaction with DPBL interventions within medical education. The forest plot shows the student satisfaction with DPBL interventions in medical education in the included studies, including their means and confidenceintervals (CI). Additionally, the overall weighted mean is indicated by the dottedred line
See this image and copyright information in PMC

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