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Objective
This study aimed to comprehensively evaluate the effect of PBL on problem-solving, self-directed learning, and critical thinking ability of pharmaceutical students through a randomized controlled trial (RCT) and meta-analysis of RCTs.
Methods
In 2021, 57 third-year pharmacy students from China Pharmaceutical University were randomly divided into a PBL group and a lecture-based learning (LBL) group. Mean scores were compared between the two groups for problem-solving, self-directed learning, communication skills, critical thinking, and final exam grades. Students’ feedback on the implementation of PBL was also collected. A meta-analysis was subsequently performed. Two authors independently conducted a comprehensive search of two databases (PubMed and CNKI). Eligible studies with effective data were included and the valuable data were extracted for analysis. Quality of involved studies was assessed by the Cochrane Collaboration’s tool. All analyses of statistics were conducted using the ‘metafor’ package in R software.
Results
The PBL group had significantly higher mean scores for problem-solving (8.43±1.56) and self-directed learning (7.39±1.19) than the LBL group (7.02±1.72 and 6.41±1.28, respectively). The PBL group also showed better communication skills (8.86±1.47) than the LBL group (7.68±1.89). The mean level of critical thinking was significantly higher in the PBL group than the LBL group (p = 0.02). The PBL group also had better final exam grades (79.86±1.38) compared to the LBL group (68.1±1.76). Student feedback on PBL implementation was positive. The outcome of subsequent meta-analysis including 8 eligible studies involved 1819 participants showed that the use of PBL significantly improved problem-solving ability (SMD = 1.12, 95% CI = 0.25–1.99) and PBL was also associated with better performance in self-directed learning (SMD = 1.55, 95% CI = 0.64–2.45). However, there was no significant difference in the final exam score in the PBL group compared to the LBL control group (SMD = 0.23, 95% CI = -0.08–0.53).
Conclusion
This study found that PBL is an effective teaching method for pharmacy students.

研究目的
本研究旨在通过随机对照试验（Randomized Controlled Trial, RCT）及其元分析，全面评估基于问题的学习（Problem-Based Learning, PBL）对药学专业学生问题解决能力、自主学习能力及批判性思维能力的影响。
研究方法
2021年，来自中国药科大学的57名大三药学专业学生被随机分为基于问题的学习组（PBL组）与讲授式学习组（Lecture-Based Learning, LBL组）。比较两组学生在问题解决能力、自主学习能力、沟通能力、批判性思维能力及期末考试成绩的平均得分，同时收集学生对PBL实施情况的反馈意见。
随后开展元分析。由2名研究者独立对PubMed及中国知网（CNKI）两个数据库进行全面检索，纳入符合标准且具备有效数据的研究，提取有效数据进行分析；采用Cochrane协作网偏倚风险评估工具对纳入研究的质量进行评价。所有统计学分析均通过R软件中的‘metafor’程序包完成。
研究结果
PBL组在问题解决能力（8.43±1.56）及自主学习能力（7.39±1.19）上的平均得分显著高于LBL组（分别为7.02±1.72与6.41±1.28）。PBL组的沟通能力得分（8.86±1.47）亦优于LBL组（7.68±1.89）。PBL组的批判性思维能力平均水平显著高于LBL组（p=0.02）。PBL组的期末考试成绩（79.86±1.38）亦优于LBL组（68.1±1.76）。学生对PBL实施的反馈呈积极态度。
后续纳入8项符合标准的研究、共1819名受试者的元分析结果显示，采用PBL可显著提升学生的问题解决能力（标准化均数差（Standardized Mean Difference, SMD）=1.12，95%置信区间（Confidence Interval, CI）=0.25~1.99），且PBL与学生自主学习能力的改善显著相关（SMD=1.55，95%CI=0.64~2.45）。但PBL组与LBL对照组的期末考试成绩并无显著差异（SMD=0.23，95%CI=-0.08~0.53）。
研究结论
本研究表明，基于问题的学习（PBL）是一种适用于药学专业学生的有效教学方法。