The efficacy of bilingual immunology teaching on undergraduates in China: a systematic review and meta-analysis

Entering the 21st century, the Chinese government has vigorously promoted bilingual education in higher education (HE) to better integrate with the global world and enhance international competitiveness. The overall effect of bilingual immunology teaching in China has not been assessed. Therefore, this systematic review and meta-analysis aim to review and evaluate the efficacy of bilingual immunology teaching in universities/colleges in China. A systematic search of the Chinese Science Citation Database of China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, SinoMed, Web of Science, the Cochrane Library, PubMed, and two key academic search engines was conducted to collect studies published from 2001 to July 18, 2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to guide the reporting of the study selection process. The quality of the included studies was assessed using the MINORS for non-randomized studies. Meta-analyses were conducted using Cochrane’s Review Manager 5.3 software and Stata17.0 software based on random effects models. A total of nine studies with 939 students were included in this study. Results showed that implementation of bilingual teaching significantly enhanced the percentage of students with a course score above 80 [RD = 0.59, 95% CI (0.39,0.80), p < 0.001], the professional English proficiency [RD = 0.59, 95% CI (0.29,0.90), p < 0.001], and the ability of English application [RD = 0.36, 95%CI (0.13, 0.59), p = 0.003]. Due to the number and quality of included studies, the findings need to be confirmed by more high-quality studies in the future. Bilingual immunology instruction constitutes a highly effective pedagogical strategy that enhances students’ academic performance, professional English proficiency, and capacity to apply discipline-specific terminology. This approach fosters the expansion of students’ international perspectives and promotes greater adaptability in global academic and professional contexts.