Active learning in diabetes education for health professions students: a narrative synthesis of effectiveness and implementation considerations

BACKGROUND: Diabetes is a growing global health burden, requiring future health professionals to develop strong knowledge, clinical reasoning, and patient education skills. Active learning approaches, such as simulation, flipped classrooms, and gamification, are increasingly used to strengthen diabetes education, yet evidence remains fragmented. OBJECTIVE: To synthesize recent evidence on the effectiveness and implementation of active learning strategies in diabetes education for pre-licensure health professions students. METHODS: We conducted a structured narrative review of peer-reviewed studies published between 2010 and 2025. Eligible studies included randomized controlled trials, quasi-experimental, and pre-post designs evaluating active learning interventions in pre-licensure medical, nursing, or pharmacy programs. Outcomes included knowledge, skills, confidence, engagement, and satisfaction. Study quality was appraised using MERSQI. RESULTS: Twenty studies met inclusion criteria (10 RCTs, 3 quasi-experimental, 7 pre-post). Simulation and gamification demonstrated the most consistent improvements in knowledge, skills, and learner engagement. Flipped classroom results were mixed, with effectiveness dependent on learner preparation and integration with experiential components. Technology-enhanced experiential approaches showed promise but faced scalability and resource challenges. Implementation factors including faculty time, infrastructure, and equity considerations substantially influenced outcomes. CONCLUSIONS: Active learning strategies enhance diabetes education for health professions students, with simulation and gamification showing the strongest evidence of effectiveness. However, sustainability and scalability remain limited by resource intensity and variable learner preparation. Future research should address long-term knowledge retention, equity across contexts, and cost-effectiveness to guide broader adoption.