Effectiveness of Case-Based Learning Versus Lecture-Based Learning in Enhancing Critical Thinking and Retention in Pharmacology: A Mixed-Methods Cross-Sectional Study From Mauritius

Introduction: Pharmacology is a well-established branch of medicine taught in the preclinical years, encompassing the study of drugs, their mechanisms of action, dosing, adverse effects, and therapeutic applications. The primary objective of this mixed-methods cross-sectional study was to evaluate the comparative effectiveness of case-based learning (CBL) versus lecture-based learning (LBL) in pharmacology at Sir Seewoosagur Ramgoolam Medical College, Mauritius. Materials and methods: A mixed-methods cross-sectional study was conducted at Sir Seewoosagur Ramgoolam Medical College in Mauritius from September to December 2025. Quantitative data were processed and analyzed using SPSS Statistics version 31.0 (IBM Corp., Armonk, NY, USA). Qualitative data were analyzed using NVivo 15 software (QSR International, Melbourne, Australia) through inductive thematic analysis. Results: A total of 318 of 336 students participated in the quantitative component of the study, yielding a response rate of 94.64%. The mean age of participants was 22.71 ± 1.56 years. Overall, 129 (78.2%) female and 134 (87.6%) male students preferred CBL, whereas 36 (21.8%) female and 19 (12.4%) male students preferred LBL, citing that it was easier to follow without prior preparation (p = 0.027). Similarly, 137 (83.0%) female and 139 (90.8%) male students preferred CBL, while 28 (17.0%) female and 14 (9.2%) male students preferred LBL for reducing confusion or misunderstanding about the topic (p = 0.040). Clinical-phase students were more likely to prefer CBL for future sessions compared with preclinical students (adjusted OR 3.720, 95% CI 1.095-12.637; p = 0.035). Male students were more likely than female students to report that CBL was easier to follow without prior preparation (adjusted OR 2.003, 95% CI 1.024-4.020; p = 0.040) and that it reduced confusion or misunderstanding (adjusted OR 1.968, 95% CI 1.074-3.608; p = 0.042). Thematic analysis of qualitative data generated six key themes: cognitive engagement, application, recall, metacognition, interaction, and perceptions of learning format. Conclusions: This study demonstrates that students in both preclinical and clinical semesters, and across genders, generally preferred CBL over traditional LBL. Participants reported that CBL was easier to follow without prior preparation and helped reduce confusion or misunderstanding in pharmacology learning.