A four-stage progressive teaching model integrating Kolb’s experiential learning cycle and BOPPPS in clinical microbiology laboratory education

Abstract Background Under digital technology transformation, medical laboratory education faces challenges of theory-practice disconnection and assessment misalignment. This study aimed to evaluate a novel four-stage progressive smart practice teaching model integrating Kolb's experiential learning theory and the BOPPPS model in the course Clinical Microbiology Laboratory Technology. Methods A non-randomized controlled quasi-experimental design was adopted. The control group (n = 149, three natural classes of 2022-grade) received traditional didactic instruction, while the experimental group (n = 142 for examination; n = 144 for questionnaire) received the new model for one semester. Evaluations included a unified final theoretical examination and a self-developed 25-item, 4-dimension teaching experience questionnaire (Cronbach’s α = 0.989; KMO = 0.927). Results The experimental group scored significantly higher on the final theoretical examination (68.61 ± 10.49 vs.55.59 ± 12.96, t = −9.443, P < 0.001, Cohen's d ≈ 1.10), with a lower failure rate (< 60: 15.5% vs.55.0%) and a higher excellence rate (≥ 80: 14.8% vs.1.3%; χ² = 47.79, P < 0.001). However, no significant difference was found in total course scores (74.32 ± 10.98 vs.72.80 ± 7.36, P = 0.169). One possible explanation is a "score deflation" effect: because the experimental group was assessed under stricter, competency-based criteria (e.g., design thinking, reflective practice) whereas the control group used completion-oriented scoring, their lower raw scores on these components may not reflect lower ability. This interpretation remains speculative, as unified assessment criteria were not available for cross-group comparison. Questionnaire results showed positive subjective experiences across all four dimensions (teaching process perception: 4.38 ± 0.66; learning engagement: 4.26 ± 0.69; competency development: 4.34 ± 0.64; professional identity: 4.39 ± 0.61). Qualitative feedback from 132 valid open-ended responses indicated that 85 students (64.2%) identified laboratory-based hands-on learning as the most impressive component. Conclusions The new model was associated with significantly higher comprehensive application of theoretical knowledge and more positive subjective learning experiences, particularly in professional identity. However, structural misalignment between conventional assessment systems and reformed teaching objectives may have obscured the model's value-added effects, underscoring that teaching reform must advance in tandem with assessment reform.