The effects of case-based, problem-based, and team-based learning on nursing students’ problem-solving, self-directed learning, and communication skills: a systematic review and meta-analysis

Modern teaching methods, including case-based learning (CBL), problem-based learning (PBL), and team-based learning (TBL), offer significant advantages over traditional teaching by promoting active student engagement and practical application. However, a systematic and comprehensive evaluation of the effectiveness of the three modern teaching methods in nursing education remains lacking. This study aims to evaluate the effects of CBL, TBL, and PBL on nursing students’ problem-solving abilities, self-directed learning, and communication skills. A comprehensive literature search was conducted using the following databases: PubMed, Web of Science, EMBASE, CINAHL, and the Cochrane Library, up to May 2025. We included experimental and quasi-experimental studies with control groups that quantitatively compared the effects of CBL, PBL, or TBL with other teaching methodologies in nursing students. The risk of bias was judged using standard tools. Effect sizes were estimated using a random-effects model and reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup meta-analyses were conducted to compare intervention effects based on intervention methods, duration, student grade, study design, and sample size, along with heterogeneity tests, publication bias tests, and sensitivity analyses. From an initial pool of 4581 articles, 27 were included in the systematic review, among which 16 (3 experimental studies and 13 quasi-experimental studies with a control group) were used for meta-analysis. Modern teaching methods significantly improved nursing students’ problem-solving abilities (SMD = 1.05, 95% CI: 0.57–1.53), self-directed learning (SMD = 0.57, 95% CI: 0.43–0.71), and communication skills (SMD = 1.80, 95% CI: 0.80–2.80). Specifically, CBL (SMD = 1.36, 95% CI: 0.19–2.52), PBL (SMD = 0.56, 95% CI: 0.35–0.76), and TBL (SMD = 1.52, 95% CI: 0.21–2.83) all substantially enhanced students’ problem-solving capabilities. TBL (SMD = 1.94, 95% CI: 0.26–3.62) significantly improved communication skills, while PBL (SMD = 1.69, 95% CI: -0.45-3.83) showed a non-significant effect in communication skills. Modern teaching methods can effectively enhance the problem-solving abilities, self-directed learning, and communication skills of nursing students. Future research should focus on larger sample sizes, higher methodological quality, more rigorous study designs, and the inclusion of diverse learning outcomes. The review was preregistered with the International Prospective Register of Systematic Reviews (PROSPERO) (02/06/2025, #CRD420251060257).