Application of blended learning in basic medical courses for medical students: a systematic review and meta-analysis

Blended learning is used in basic medical education, but its effects may differ across courses, student groups, and instructional designs. We examined whether blended learning, compared with traditional face-to-face teaching, was associated with student satisfaction and performance on course-specific theoretical knowledge tests. A search was performed across databases, including PubMed, Web of Science, Cochrane Library, Education Resources Information Center (ERIC), China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and VIP Chinese Science and Technology Journals Database. Studies comparing the effectiveness of blended learning with traditional face-to-face teaching in medical courses were included, with eligibility spanning from the inception of these databases up to August 30, 2025. Across 26 controlled studies (1 randomized trial and 25 non-randomized studies, n = 4,668), blended learning was associated with better outcomes than traditional face-to-face teaching in two key areas. Student satisfaction was higher (OR = 4.88, 95% CI = 2.83–8.42, p < 0.001). Additionally, performance on course-specific theoretical knowledge tests improved (SMD = 1.30, 95% CI = 0.95–1.65, p < 0.001). Leave-one-out sensitivity analysis did not materially change the pooled estimate. Exploratory subgroup analyses suggested possible improvements in performance on course-specific theoretical knowledge tests across educational levels and subjects. This systematic review and meta-analysis of eligible studies suggests that blended learning in basic medical education may improve medical students’ performance on course-specific theoretical knowledge tests and may be associated with higher student satisfaction.