Evidence-based medicine combined with patient-oriented problem-solving teaching method: an effective tool for learning medical immunology

Evidence-based medicine combined with patient-oriented problem-solving teaching method: an effective tool for learning medical immunology | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evidence-based medicine combined with patient-oriented problem-solving teaching method: an effective tool for learning medical immunology Zhejuan Shen, Hong Yang, Guiqing Li, Xiao Han, Boshao Deng, Chengying Yang, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7600082/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Medical immunology is a core course in modern medical education, playing a crucial role in cultivating students' medical literacy and clinical thinking abilities. In recent years, the Evidence-based medicine (EBM) and Problem-oriented patient solving (POPS) teaching methods have been widely applied in medical education and have achieved remarkable outcomes in graduate education in Traditional Chinese Medicine and clinical medicine. However, the application of the EBM combined with POPS teaching method in medical immunology courses remains underexplored. Objective This study aims to investigate the application effect of the EBM combined with POPS teaching method in medical immunology courses, to provide a reference for a novel teaching model and contribute to the cultivation of high-quality medical talents through the teaching of medical immunology. Methods This study is the first to apply the EBM combined with POPS teaching method in medical immunology courses. The teaching effectiveness was evaluated through standardized questionnaires, post-class tests, and students' feedback. Additionally, the teaching effect evaluation index system was constructed based on expert consultations. The overall teaching effectiveness of this method was comprehensively analyzed by combining students' feedback questionnaires, theoretical test results, and course review writing. Conclusion The EBM combined with POPS teaching method significantly outperforms traditional teaching methods in enhancing student learning participation, knowledge acquisition, autonomous learning ability, and team cooperation skills. This method effectively promotes classroom interaction and fosters students' clinical and scientific research thinking, providing a valuable reference for the development of medical education courses. Evidence-based medicine Problem-oriented patient solving Medical immunology Teaching practice Questionnaire survey Figures Figure 1 Figure 2 Introduction Under the comprehensive implementation of the Healthy China strategy[ 1 ], the rapid advancement of life sciences, biotechnology, information technology, and artificial intelligence (AI) has precipitated an exponential expansion of medical knowledge, necessitating continuous paradigm updates in clinical practice and research methodologies[ 2 ]. This transformative development imposes heightened demands on clinicians - requiring urgent mastery of cutting-edge technologies such as precision medicine and AI-assisted diagnosis and treatment to optimize the entire disease prevention-diagnosis-treatment continuum. In this context, the medical education system is constantly evolving, and its core mission is to cultivate interdisciplinary medical talents with lifelong learning ability, effective integration of technological innovation, and continuous improvement of service quality in a dynamic medical environment[ 3 – 5 ]. Current educational innovation focuses on exploring the path of integration of theory and practice, with how to meet the challenges of the new era through diversified educational strategies has become an important focus of medical education reform. As a frontier discipline in life sciences, medical immunology plays a pivotal role in deciphering immune-related disease mechanisms and developing novel diagnostic-therapeutic strategies[ 6 , 7 ]. Traditional pedagogy predominantly employs Lecture-based learning (LBL), supplemented by some experimental techniques aligned with textbook chapters. However, this model exhibits significant limitations: teaching effectiveness excessively relies on instructors' lecturing proficiency while failing to stimulate students' self-directed inquiry[ 8 , 9 ]; more critically, students generally lack practical training in translating immunological theories into clinical problem-solving competencies. This capability gap starkly contrasts with the demand for high-caliber medical professionals under the Healthy China initiative, highlighting the urgency of reforming immunology pedagogy[ 10 ]. Currently, evidence-based medicine (EBM), recognized as the gold standard for clinical practice, is driving the transformation of medical education from experience-oriented to evidence-driven paradigms[ 11 – 14 ]. Through systematic evidence integration and critical appraisal, EBM provides scientific foundations for medical decision-making, research innovation, and pedagogical activities[ 15 ]. Thirty decades of practice has proved that EBM education has significantly improved the efficiency of knowledge internalization and clinical thinking ability of medical students. However, the existing teaching model overemphasizes the hierarchical classification of evidence, which makes students fall into the dilemma of "evidence dependence" and fails to cultivate students' ability to synthesize multi-dimensional information in complex clinical situations. Developing innovative teaching models that leverage EBM's strengths while promoting comprehensive clinical literacy has become an urgent challenge for medical education researchers[ 16 – 18 ]. The problem-oriented patient solving (POPS) pedagogy, pioneered by Parker A. Small Jr. and Susan M. Johnson at the University of Florida in the 1970s, represents a case-driven instructional innovation. Through this approach, student teams apply fundamental theories to clinical contexts, honing collaborative problem-solving skills via resource utilization and peer interaction[ 19 , 20 ]. Comparative studies demonstrate that compared with traditional methods, POPS better motivates learning, enhances comprehensive competencies, and facilitates the translation of basic science knowledge to clinical situations[ 21 , 22 ], suggesting its synergistic potential with EBM concepts in medical immunology education. Although EBM and POPS have been independently implemented in medical education[ 20 , 23 ] (Fig. 1 ), their synergistic integration has not been systematically investigated. Notably, preliminary domestic studies—such as those combining EBM and POPS during clinical internships for senior medical students and in Traditional Chinese Medicine postgraduate training—have shown promising results in enhancing clinical competency. These findings highlight a critical opportunity for immunology curriculum reform: leveraging the complementary strengths of both pedagogies during basic medical education could address the persistent "theory-practice gap" in traditional immunology instruction. In order to make up for this gap, our study combined EBM and POPS teaching method to apply to the teaching reform of medical immunology, and evaluated its effect through a multi-dimensional evaluation framework, standardized questionnaire survey, score analysis and other indicators. Research Methods Research Subject s This study was conducted at the School of Basic Medical Sciences of Army Medical University of the People's Liberation Army of China. The current research was informed consent was obtained from all student participants. A total of 84 students and 9 medical immunology teachers with extensive teaching experience were recruited for this study. Teaching Conten t This study employed immediate hypersensitivity as the instructional content. Immediate hypersensitivity reaction is a common type of hypersensitivity reaction in clinical practice, also known as anaphylaxis. These characteristics necessitate clinicians to perform comprehensive case analyses for developing appropriate prevention and treatment strategies. The inherent combination of theoretical complexity and clinical variability renders immediate hypersensitivity an ideal model for evaluating the efficacy of EBM integrated with the POPS teaching approach in medical immunology education. Teaching design In this study, students were divided into two groups, the control group and the experimental group. The control group (n = 34) adopted traditional LBL teaching method: standardized learning materials were distributed to students before class; In the classroom teaching, the teacher systematically explained the pathogenesis, clinical manifestations, treatment and prevention strategies of type I hypersensitivity by integrating typical clinical cases. After class, students were asked to submit an evidence-based medical analysis of allergy mechanisms. The experimental group (n = 54) implemented EBM combined with POPS teaching method, using a three-stage progressive teaching design (Fig. 2 ). In the pre-class preparation phase, teachers developed course content based on the POPS pedagogical approach. Students were divided into learning groups and required to conduct systematic literature searches to gather relevant EBM evidence. Each group analyzed key aspects of representative clinical cases, including pathogenesis, clinical manifestations, and treatment protocols, ultimately formulating structured discussion outlines. In the course implementation phase, under the guidance of teachers, each learning group carried out case discussions based on the evidence-based evidence prepared in advance. Teachers conducted a comprehensive evaluation of students' clinical thinking ability, innovative consciousness and teamwork performance through formative assessment, and systematically sorted out the knowledge points at the end of the course. Meanwhile, a standardized questionnaire was adopted to evaluate the implementation effect of the EBM combined with POPS teaching method. In the after-class expansion phase: (1) Students should complete an immune-related review paper. (2)Students should be arranged to participate in clinical internships. By observing the diagnosis and treatment of actual cases and performing practical operations, students can enhance the integration of theoretical knowledge with clinical practice, thereby deepening their understanding and application ability in the field of allergy research and treatment. Questionnaire This study employed the Delphi expert consultation method to establish a teaching effectiveness evaluation index system for medical immunology courses. During the expert consultation process, a Likert scale was utilized to assess the importance of each indicator, with four rating levels: "not important" (1-point), "moderately important" (2-point), "important" (3-point), and "very important" (4-point). Nine experts with extensive experience in basic medical education participated in two rounds of consultation. Through systematic analysis and expert deliberation, a comprehensive multi-dimensional evaluation system was developed, consisting of 4 first-level indicators, 12 second-level indicators, and 31 third-level indicators. The first-level indicators included student response, learning outcomes, knowledge application, and overall impact. The second-level indicators encompassed understanding level, acceptance degree, participation level, satisfaction, theoretical knowledge mastery, clinical thinking development, learning attitude improvement, application depth, application scope, duration of effect, personal growth, and group benefits. Based on the expert consensus, a standardized teaching effect evaluation questionnaire was developed to evaluate and compare the application of evidence-based medicine combined with POPS teaching method and LBL teaching method in medical immunology teaching. The entire research process strictly adhered to the Delphi method protocol, and all expert suggestions were thoroughly discussed and incorporated into the final evaluation system. Statistical analysis Statistical analysis was performed using the software SPSS 27.0. Continuous variables were presented as mean ± standard deviation (x̄±SD). Students’ questionnaire data were analyzed using an independent t-test. Independent t-test was used to compare the acceptance and satisfaction of teaching methods, learning engagement, learning effectiveness, and long-term impact on students between the two groups. A p value of less than 0.05 was considered statistically significant. Results A total of 84 students were recruited in this study, including 33 males and 55 females, who were mainly second-year undergraduate students majoring in clinical or basic medicine. There were 14 males (41.2%) and 20 females (58.8%) in the LBL group. There were 19 males (35.2%) and 35 females (64.8%) in the EBM combined with POPS group. At the end of the course, an anonymous questionnaire survey was conducted to systematically evaluate the effect of LBL teaching and POPS teaching integrated with ebm in medical immunology. A 10-point visual analogue scale (VAS) was used to self-evaluate the teaching quality, with 0 indicating "no effect", 5 indicating "moderate", and 10 indicating "completely perfect". In addition to completing the questionnaires, participants from both groups were invited to provide suggestions for improving the two teaching methodologies. The questionnaire consisted of four modules with a total of 17 or 20 multiple-choice questions, covering the four dimensions of students' acceptance and satisfaction with teaching methods (6 questions, LBL group 3 questions), learning engagement (4 questions), learning effect (6 questions) and long-term impact (4 questions). Table 1 presents survey data on student acceptance and satisfaction with teaching methods. Statistical analysis showed that compared with the LBL group, students in the EBM + POPS group had a higher evaluation of the teacher's teaching and the overall classroom (8.46 ± 1.679 vs. 3.32 ± 1.007, p < 0.001). The close correlation between curriculum content and clinical practice was widely recognized (7.93 ± 1.747 vs. 3.35 ± 1.070, p < 0.001). In addition, the questionnaire results also showed that students were more interested in EBM combined with POPS teaching method (8.42 ± 1.643), and gave high scores for its applicability in courses such as Medical immunology (7.81 ± 1.694). It was believed that this teaching method was helpful to deepen the thinking of career development than traditional teaching (7.74 ± 1.835 vs. 2.79 ± 1.200, p < 0.001). Table 1 Students' acceptance and satisfaction with teaching methods. Question LBL EBM + POPS t p 1 You find the application of EBM combined with POPS in Medical Immunology teaching appropriate. - 8.43 ± 1.909 - - 2 You find this teaching method more engaging than traditional lectures. - 8.42 ± 1.643 - - 3 You are satisfied with the instructor’s teaching content and classroom organization. 3.32 ± 1.007 8.46 ± 1.679 17.946 < 0.001 4 You believe the course content is closely integrated with clinical practice. 3.35 ± 1.070 7.93 ± 1.747 15.230 < 0.001 5 You feel the course has enhanced your reflection on career development. 2.79 ± 1.200 7.74 ± 1.835 15.287 < 0.001 6 You support applying the EBM-POPS method in more courses. - 7.81 ± 1.694 - - The results of the survey on learning participation in Table 2 show that the students in the group taught by EBM combined with POPS were significantly better than those in the LBL group on all the engagement indicators. The results showed that the frequency of students participating in class-related activities (group discussion/case analysis/knowledge exchange) for more than 3 times was significantly increased (7.02 ± 1.848 vs. 2.53 ± 1.107, p < 0.001), and the rate of completing homework before class and after class on time was significantly increased (7.09 ± 1.696 vs. 3.32 ± 1.065, p < 0.001). In terms of classroom interaction, active response (6.54 ± 1.723 vs. 2.32 ± 1.007, p < 0.001) and teacher-student interaction frequency increased significantly; More importantly, the proportion of students in the EBM + POPS group who maintained their enthusiasm for learning was also significantly superior (6.83 ± 1.611 vs. 3.32 ± 1.007, p < 0.001). Table 2 Students' learning participation. Question LBL EBM + POPS t p 1 You actively participated in 3 or more immunology-related learning activities (such as group discussions, case analyses, knowledge exchanges, etc.). 2.53 ± 1.107 7.02 ± 1.848 14.245 < 0.001 2 You completed pre-class preparations and assignments on time. 3.32 ± 1.065 7.09 ± 1.696 12.803 < 0.001 3 In class, you frequently interacted with the instructor or answered questions. 2.32 ± 1.007 6.54 ± 1.723 14.468 < 0.001 4 You maintained enthusiasm during class. 3.32 ± 1.007 6.83 ± 1.611 12.579 < 0.001 Table 3 presents the survey results on learning outcomes. Questionnaire analysis showed that the combination of EBM and POPS teaching method helped students systematically master the core theoretical knowledge of medical immunology (7.33 ± 1.671 vs. 2.94 ± 1.413, p < 0.001). The ability of students to analyze medical problems using immunological principles was significantly improved (7.41 ± 1.868 vs. 3.09 ± 1.422, p < 0.001). The data of homework scores after class showed that this method helped to improve students' academic performance relative to the LBL group (7.61 ± 1.774 vs. 3.09 ± 1.423, p < 0.001). Through continuous evidence-based information retrieval and literature review in POPS course, students' ability of literature retrieval and clinical evidence evaluation was effectively improved (6.93 ± 1.714 vs. 2.97 ± 1.507, p < 0.001). This teaching method can not only cultivate students' scientific research thinking (7.24 ± 1.516 vs. 2.82 ± 1.403, p < 0.001), but also stimulate students' interest in learning and enhance students' motivation for autonomous learning (7.43 ± 1.573 vs. 2.91 ± 1.379, p < 0.001). Table 3 Students' learning participation. Question LBL EBM + POPS t p 1 The course helped you master core theoretical knowledge of Medical Immunology. 2.94 ± 1.413 7.33 ± 1.671 13.217 < 0.001 2 The course contributed to improving your exam performance. 3.09 ± 1.443 7.61 ± 1.774 13.081 < 0.001 3 Your ability to analyze medical issues using immunology knowledge has improved (such as allergy mechanisms, vaccine principles, etc.). 3.09 ± 1.422 7.41 ± 1.868 12.259 < 0.001 4 The course enhanced your literature retrieval and clinical evidence evaluation skills. 2.97 ± 1.507 6.93 ± 1.714 11.360 < 0.001 5 The course increased your interest in learning and self-directed motivation. 2.91 ± 1.379 7.43 ± 1.573 14.151 < 0.001 6 The course fostered your scientific research mindset. 2.82 ± 1.403 7.24 ± 1.516 13.936 < 0.001 The results of long-term evaluation of teaching effect in Table 4 show that compared with the LBL teaching group, students receiving EBM combined with POPS teaching method showed significant advantages in multiple dimensions. Specifically, students in this group showed a more solid mastery of immunological knowledge (7.39 ± 1.420 vs. 2.91 ± 1.379, p < 0.001). The medical professional identity was significantly enhanced through evidence-based teaching and case analysis (7.13 ± 1.981 vs. 2.91 ± 1.525, p < 0.001). More importantly, the vast majority of students expressed confidence in applying their immunology knowledge to clinical practice and research in the future (7.31 ± 1.851 vs. 2.91 ± 1.443, p < 0.001). Moreover, the effect of EBM combined with POPS in improving students' professional competence was significant (7.35 ± 2.039 vs. 2.79 ± 1.200, p < 0.001), indicating that the application of EBM combined with POPS had a continuous positive impact on students' professional development. Table 4 Long-term impact on students. Question LBL EBM + POPS t p 1 After the course, you retained some immunology knowledge. 3.12 ± 1.552 7.39 ± 1.420 12.984 < 0.001 2 You are confident in applying immunology knowledge to future clinical or research problems. 2.91 ± 1.443 7.31 ± 1.851 12.467 < 0.001 3 The course strengthened your professional identity in medicine. 2.91 ± 1.525 7.13 ± 1.981 11.229 < 0.001 4 The course improved your job competency (clinical skills, research ability, teamwork, communication, career development, etc.). 2.79 ± 1.200 7.35 ± 2.039 13.192 < 0.001 Discussion As one of the core courses in modern medical education system, medical immunology is of great significance to cultivate students' basic medical literacy and clinical thinking ability[ 6 , 7 ]. In recent years, EBM has been widely used in the field of medical education, which provides strong support for the innovation of teaching methods [12–15] . At the same time, POPS teaching method has been widely promoted and applied in physiology, immunology and other basic medical courses due to its student-centered and practical ability training characteristics[ 19 , 20 ]. In addition, the combination of EBM and POPS has achieved remarkable results in postgraduate education of traditional Chinese medicine and clinical medicine, indicating that the application of this combination in other medical courses has broad development prospects. This study is the first time to apply EBM combined with POPS teaching method in medical immunology teaching, which is novel. The teaching effect was evaluated by standardized questionnaire survey, quizzes after class and the completion of students' review. The results of the study showed that this teaching method was significantly better than the traditional LBL teaching method in multiple dimensions. In the process of constructing the evaluation index system of teaching effect of medical immunology course, we referred to the opinions of expert consultation before class. It is gratifying to note that nine experts were generally satisfied with the EBM combined with POPS teaching method. These experts are excellent teachers with rich teaching experience, and they agree with and are satisfied with our teaching method, mainly for the following reasons: first, teachers can observe that students actively participate in learning in the classroom, showing a high level of participation and enthusiasm. Secondly, students are able to understand and apply relevant knowledge, propose reasonable solutions, and demonstrate learning outcomes during the process of literature search and clinical evidence evaluation. In addition, students were able to collaborate, communicate, and coordinate effectively within groups to solve case problems together. Teachers gave positive comments on the promotion of EBM combined with POPS teaching method. The previous literature search strengthened their confidence in the application of this teaching method in medical education courses. This teaching method not only has a positive effect on the personal growth of teachers, but also provides useful thinking for the construction of high-quality courses and the cultivation of medical talents with core competitiveness. According to the results of the students' feedback questionnaire after class, the teaching method of EBM combined with POPS scored significantly higher than the traditional teaching method in terms of students' acceptance and satisfaction, learning engagement, learning effect and long-term influence on students. To be specific: first of all, case-oriented course content and student-centered classroom organization are more easily accepted by students. The EBM philosophy, which runs through it, enables students to further integrate theory with clinical practice, thereby increasing their thinking about their future career development. Secondly, EBM combined with POPS teaching method can significantly enhance classroom interaction and promote active communication and collaboration between students. This interaction not only improved learning efficiency, but also stimulated students' enthusiasm for learning and made them more active to participate in the evidence-based investigation before class and review consolidation after class. Through literature review, group cooperation and class discussion before class, students deepened their understanding and application of knowledge, and further consolidated their learning results. In addition, this teaching method also cultivated students' independent learning ability and helped them better grasp the core theoretical knowledge of medical immunology. Students can actively explore and expand their knowledge field, and improve their ability to solve medical problems with immunology knowledge. The teaching model based on clinical cases, combined with extensive literature review, not only cultivates students' clinical thinking and scientific research thinking, but also improves their ability to evaluate clinical evidence. Finally, compared with the traditional passive learning method, the EBM combined with POPS teaching method puts more emphasis on the active participation and autonomous learning of students, making the learning process more interesting and stimulating. This teaching method has had a profound long-term impact on students. Even after the course, students can still remember some immunological knowledge and apply it to clinical practice and scientific research in the future, so as to consolidate their learning results and improve their competency. To more accurately assess long-term learning outcomes, we not only conducted a theoretical test after the course, but also asked students to submit a review of the immunology course. In the theory examination, students in the EBM combined with POPS group achieved higher scores. This may be because the teaching method of EBM combined with POPS emphasizes active learning and active participation of students, enabling them to understand the topic more deeply through group discussions and case analysis in class. This deep understanding helps students to better apply and express what they have learned in theoretical examinations, thus achieving better results. For review writing, students in the EBM combined POPS group achieved higher scores for literature review and citation, arguments and opinions, content integrity, scientific rigor, and accuracy. The results showed that the combination of EBM and POPS teaching method had a significant effect on the cultivation of students' scientific research thinking. Through extensive literature search and evidence-based medicine evidence evaluation, this group of students formed a comprehensive and systematic cognition of disease-related knowledge, so as to provide more powerful reference and support in the review papers[ 24 ]. In addition, the EBM combined with POPS teaching method focused on the cultivation of students' self-directed learning ability. Through group collaboration and discussion, students are encouraged to think deeply and analyze problems, so that they can actively explore and articulate more convincing arguments in their thesis writing. Compared with the traditional teaching group, the students in the EBM combined with POPS group showed higher integrity in their papers, demonstrating scientific rigor and accuracy. Therefore, this teaching method can effectively cultivate students' ability of literature retrieval and clinical evidence evaluation, and lay a solid foundation for the long-term development of students' scientific research and clinical career. However, there are some limitations to our study. (1) There may be selection bias, because our sample is mainly from the sophomore majoring in basic medicine and clinical medicine, who are still in the stage of college learning, have not yet been fully exposed to clinical practice, and have limited improvement in clinical practice skills. (2) Since the two groups of students are taught by different teachers, the difference of teachers' personal styles may have an impact on the teaching quality, which is difficult to completely eliminate. (3) The results of the study may be affected by the subjective factors of the participants. Student academic performance and paper quality may be influenced by individual differences, learning motivation, and learning styles, and although attempts have been made to control for these factors in research designs, there is still some difficulty in completely eliminating their influence. In conclusion, EBM combined with POPS is an efficient teaching method that has achieved significant improvements in several aspects compared to the traditional teaching model. Through group learning and collaboration, this model can effectively promote classroom interaction, significantly improve learning efficiency, knowledge acquisition ability, autonomous learning ability and team cooperation ability. In addition, the teaching model of EBM combined with POPS focuses on cultivating students' clinical thinking and scientific research thinking, which helps students to understand and apply medical theoretical knowledge more deeply. Therefore, this teaching model provides a useful reference for the course construction under the background of modern medical education, and contributes an important force to the cultivation of high-quality medical talents[ 11 , 25 ]. Future studies can further expand the sample size, cover more students in grade and professional background, and try to control for factors such as differences in teachers' personal styles to more fully verify the effectiveness and universality of EBM combined with POPS teaching method. Abbreviations EBM evidence-based medicine POPS problem-oriented patient solving Declarations Ethics approval and consent to participate This study was performed in accordance with the Helsinki Declaration. Students were free to opt out of the study. The questionnaire is anonymous to protect student privacy. Participation did not impact students’ evaluations. The informed consent obtained from study participants was written. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing Interests No potential conflict of interest was reported by the authors. Funding Chongqing postgraduate education and teaching reform postgraduate project [YJG233144)] and research project on educational reform of army medical university [2024B01]. Authors' contributions SZJ drafted the manuscript. SZJ, YH and LGQ took primary responsibility for questionnaire design, distribution, data collection, and collation. HX, DBS and YCY, XZY contributed to curriculum design. WYZ, GS and CJ initiated the project and developed the research framework. Acknowledgments We thank Anne Basye for her editing contributions to the first draft of the manuscript, and the expert reviewers for their input on the survey development. References Jiang Z, Jiang W, Media Integration and Mass Communication Department, China Population Communication Center, Beijing, China. Health education in the healthy china initiative 2019−2030. China CDC Wkly. 2021;3(4):78–80. Yang C, Chen Y, Qian C, Shi F, Guo Y. The data-intensive research paradigm: challenges and responses in clinical professional graduate education. Front Med. 2025 Feb 7;12:1461863. Li Y, Li J, Li B, Cao Y, Liu M, Zhang L, Zeng Z. Factors associated with the research efficiency of clinical specialties in a research-oriented hospital in China. Xue B, editor. PLOS One. 2021 Apr 28;16(4):e0250577. Fu DQ, Huang YQ, Que YH, Hong Y, Lin JQ. Factors affecting the scientific research ability and the corresponding countermeasures in clinical postgraduates. BMC Med Educ. 2023 May 5;23(1):309. Vogt M, Schuchardt N, Geissler ME, Bereuter JP, Geissler RB, Glauche I, Gerdes S, Deußen A, Günther L. Scientific competence during medical education - insights from a cross-sectional study at a german medical school. BMC Med Educ. 2024 May 28;24(1):590. Haidaris CG, Frelinger JG. Inoculating a new generation: immunology in medical education. Front Immunol. 2019 Nov 1;10:2548. Armson AJ, Meyer AJ, Losco BE, Ardakani EM, Walker BF. Immunology knowledge as one of the basic sciences that forms the foundations to developing sound clinicians. J Chiropr Educ. 2016 Oct;30(2):108–13. Ulfa Y, Igarashi Y, Takahata K, Shishido E, Horiuchi S. A comparison of team-based learning and lecture-based learning on clinical reasoning and classroom engagement: a cluster randomized controlled trial. BMC Med Educ. 2021 Dec;21(1):444. Zhang Q, Tang X, Zhao Y, Wang Z. Team-based learning vs. lecture-based learning in nursing: a systematic review of randomized controlled trials. Front Public Health. 2023 Jan 4;10:1044014. Lee GB, Chiu AM. Assessment and feedback methods in competency-based medical education. Ann Allergy Asthma Immunol. 2022 Mar;128(3):256–62. Huang T, Zhou S, Wei Q, Ding C. Team-, case-, lecture- and evidence-based learning in medical postgraduates training. BMC Med Educ. 2024 Jun 18;24(1):675. Chandran VP, Balakrishnan A, Rashid M, Khan S, Devi ES, Kulyadi GP, Nair S, Thunga G. Teaching and learning strategies of evidence based medicine: a meta-synthesis of learners and instructors perspective. Clin Epidemiol Glob Health. 2023 May;21:101280. Thomas A, Chin-Yee B, Mercuri M. Thirty years of teaching evidence-based medicine: have we been getting it all wrong? Adv Health Sci Educ. 2022 Mar;27(1):263–76. Maggio LA. Educating physicians in evidence based medicine: current practices and curricular strategies. Perspect Med Educ. 2016 Oct 25;5(6):358–61. Guyatt G. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA. 1992 Nov 4;268(17):2420. Ilic D, Hart W, Fiddes P, Misso M, Villanueva E. Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study. BMC Med Educ. 2013 Dec;13(1):169. Wyer PC. Evidence-based medicine and problem based learning a critical re-evaluation. Adv Health Sci Educ. 2019 Dec;24(5):865–78. Smith N. Evidence-based practice in medical education: team-based learning in a blended curriculum [Internet]. Medical Education; 2024 [cited 2025 May 21]. Available from: http://medrxiv.org/lookup/doi/10.1101/2024.06.25.24309485 Singh A. Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures. Adv Med Educ Pract. 2010 Dec;9. Zhang Z, Liu W, Han J, Guo S, Wu Y. A trial of patient-oriented problem-solving system for immunology teaching in China: a comparison with dialectic lectures. BMC Medical Education. 2013 Jan 28;13:11. Mohan BS, Nambiar V, Arvindkshan R. Patient-oriented Problem-solving: An Effective Educational Tool for Learning Immunology. Int Jour of Dent and Med Spec. 2017;4(1):2. Desai KN, Satapara VK, Rathod GB, Maru AM. Development and evaluation of the POPBL (patient-oriented problem-based learning) module in pathology: a comparative analysis of performance and perception among second-year pathology students. Cureus [Internet]. 2022 Sep 7 [cited 2025 May 21]; Available from: https://www.cureus.com/articles/109734-development-and-evaluation-of-the-popbl-patient-oriented-problem-based-learning-module-in-pathology-a-comparative-analysis-of-performance-and-perception-among-second-year-pathology-students Menard L, Blevins AE, Trujillo DJ, Lazarus KH. Integrating evidence-based medicine skills into a medical school curriculum: a quantitative outcomes assessment. BMJ Evid-based Med. 2021 Oct;26(5):249–50. Wang C, Yao Y, Chen Y, Chen J. The impact of evidence-based medicine curricula on information literacy among clinical medical undergraduates and postgraduates in China. BMC Medical Education. 2025 Apr 11;25(1):520. Tan X, Liu X, Shao H. Healthy china 2030: a vision for health care. Value Health Reg Issues. 2017 May;12:112–4. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7600082","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":525202474,"identity":"3ae4d761-804b-4df4-b1a8-58710bd3dd90","order_by":0,"name":"Zhejuan Shen","email":"","orcid":"","institution":"Army Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhejuan","middleName":"","lastName":"Shen","suffix":""},{"id":525202477,"identity":"a5d28146-74cd-4ae6-a37e-58ae6de94850","order_by":1,"name":"Hong Yang","email":"","orcid":"","institution":"Army Medical 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12:25:18","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":87719,"visible":true,"origin":"","legend":"","description":"","filename":"f1bff541eb3e4618bec10b8c12131be61structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7600082/v1/f7fd7086bd60b055a96b875b.xml"},{"id":93774564,"identity":"5a0aaf78-a791-47d3-89ba-77ba5f3c6331","added_by":"auto","created_at":"2025-10-17 12:25:18","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":93357,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7600082/v1/bce8008188226bea9ab8c373.html"},{"id":93775772,"identity":"4cb9c0c3-480a-48d9-a4d2-06737c906ecf","added_by":"auto","created_at":"2025-10-17 12:33:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":283658,"visible":true,"origin":"","legend":"\u003cp\u003eCurrent Research Landscape of EBM and POPS in Medical Education.\u003cstrong\u003e \u003c/strong\u003ePOPS: Problem-oriented patient solving; EBM: Evidence-based medicine. The Venn diagram illustrates the existing literature on the application of EBM and POPS in medical education. The blue sector represents recent survey literature on EBM implementation in medical education, while the orange sector denotes studies focusing on POPS-based teaching. The overlapping purple region indicates emerging research on the integrated application of EBM and POPS in medical education; however, no studies to date have specifically explored this combined approach in the context of medical immunology instruction.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7600082/v1/ce7b37aea57b2faef4af63ec.png"},{"id":93774553,"identity":"53a9ac5a-73c3-4917-a2c5-7e49ca808daf","added_by":"auto","created_at":"2025-10-17 12:25:17","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":134851,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of the Application of EBM combined with POPS Teaching Method in Medical Immunology teaching. POPS: Problem-Oriented Patient Solving; EBM: Evidence-Based Medicine.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7600082/v1/780067bfb7efa17c8efa6b1c.png"},{"id":100365481,"identity":"33276afd-5199-444b-a828-c38ddc277df8","added_by":"auto","created_at":"2026-01-16 07:55:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":976939,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7600082/v1/90b967e4-2893-4f8b-af73-51b8b9e5e15e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evidence-based medicine combined with patient-oriented problem-solving teaching method: an effective tool for learning medical immunology","fulltext":[{"header":"Introduction","content":"\u003cp\u003eUnder the comprehensive implementation of the Healthy China strategy[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], the rapid advancement of life sciences, biotechnology, information technology, and artificial intelligence (AI) has precipitated an exponential expansion of medical knowledge, necessitating continuous paradigm updates in clinical practice and research methodologies[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. This transformative development imposes heightened demands on clinicians - requiring urgent mastery of cutting-edge technologies such as precision medicine and AI-assisted diagnosis and treatment to optimize the entire disease prevention-diagnosis-treatment continuum. In this context, the medical education system is constantly evolving, and its core mission is to cultivate interdisciplinary medical talents with lifelong learning ability, effective integration of technological innovation, and continuous improvement of service quality in a dynamic medical environment[\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Current educational innovation focuses on exploring the path of integration of theory and practice, with how to meet the challenges of the new era through diversified educational strategies has become an important focus of medical education reform.\u003c/p\u003e\u003cp\u003eAs a frontier discipline in life sciences, medical immunology plays a pivotal role in deciphering immune-related disease mechanisms and developing novel diagnostic-therapeutic strategies[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Traditional pedagogy predominantly employs Lecture-based learning (LBL), supplemented by some experimental techniques aligned with textbook chapters. However, this model exhibits significant limitations: teaching effectiveness excessively relies on instructors' lecturing proficiency while failing to stimulate students' self-directed inquiry[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]; more critically, students generally lack practical training in translating immunological theories into clinical problem-solving competencies. This capability gap starkly contrasts with the demand for high-caliber medical professionals under the Healthy China initiative, highlighting the urgency of reforming immunology pedagogy[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eCurrently, evidence-based medicine (EBM), recognized as the gold standard for clinical practice, is driving the transformation of medical education from experience-oriented to evidence-driven paradigms[\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Through systematic evidence integration and critical appraisal, EBM provides scientific foundations for medical decision-making, research innovation, and pedagogical activities[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Thirty decades of practice has proved that EBM education has significantly improved the efficiency of knowledge internalization and clinical thinking ability of medical students. However, the existing teaching model overemphasizes the hierarchical classification of evidence, which makes students fall into the dilemma of \"evidence dependence\" and fails to cultivate students' ability to synthesize multi-dimensional information in complex clinical situations. Developing innovative teaching models that leverage EBM's strengths while promoting comprehensive clinical literacy has become an urgent challenge for medical education researchers[\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe problem-oriented patient solving (POPS) pedagogy, pioneered by Parker A. Small Jr. and Susan M. Johnson at the University of Florida in the 1970s, represents a case-driven instructional innovation. Through this approach, student teams apply fundamental theories to clinical contexts, honing collaborative problem-solving skills via resource utilization and peer interaction[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Comparative studies demonstrate that compared with traditional methods, POPS better motivates learning, enhances comprehensive competencies, and facilitates the translation of basic science knowledge to clinical situations[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], suggesting its synergistic potential with EBM concepts in medical immunology education.\u003c/p\u003e\u003cp\u003eAlthough EBM and POPS have been independently implemented in medical education[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), their synergistic integration has not been systematically investigated. Notably, preliminary domestic studies\u0026mdash;such as those combining EBM and POPS during clinical internships for senior medical students and in Traditional Chinese Medicine postgraduate training\u0026mdash;have shown promising results in enhancing clinical competency. These findings highlight a critical opportunity for immunology curriculum reform: leveraging the complementary strengths of both pedagogies during basic medical education could address the persistent \"theory-practice gap\" in traditional immunology instruction. In order to make up for this gap, our study combined EBM and POPS teaching method to apply to the teaching reform of medical immunology, and evaluated its effect through a multi-dimensional evaluation framework, standardized questionnaire survey, score analysis and other indicators.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Research Methods","content":"\u003cp\u003e\u003cb\u003eResearch Subject\u003c/b\u003es\u003c/p\u003e\u003cp\u003eThis study was conducted at the School of Basic Medical Sciences of Army Medical University of the People's Liberation Army of China. The current research was informed consent was obtained from all student participants. A total of 84 students and 9 medical immunology teachers with extensive teaching experience were recruited for this study.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTeaching Conten\u003c/b\u003et\u003c/p\u003e\u003cp\u003eThis study employed immediate hypersensitivity as the instructional content. Immediate hypersensitivity reaction is a common type of hypersensitivity reaction in clinical practice, also known as anaphylaxis. These characteristics necessitate clinicians to perform comprehensive case analyses for developing appropriate prevention and treatment strategies. The inherent combination of theoretical complexity and clinical variability renders immediate hypersensitivity an ideal model for evaluating the efficacy of EBM integrated with the POPS teaching approach in medical immunology education.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eTeaching design\u003c/h2\u003e\u003cp\u003eIn this study, students were divided into two groups, the control group and the experimental group. The control group (n\u0026thinsp;=\u0026thinsp;34) adopted traditional LBL teaching method: standardized learning materials were distributed to students before class; In the classroom teaching, the teacher systematically explained the pathogenesis, clinical manifestations, treatment and prevention strategies of type I hypersensitivity by integrating typical clinical cases. After class, students were asked to submit an evidence-based medical analysis of allergy mechanisms.\u003c/p\u003e\u003cp\u003eThe experimental group (n\u0026thinsp;=\u0026thinsp;54) implemented EBM combined with POPS teaching method, using a three-stage progressive teaching design (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). In the pre-class preparation phase, teachers developed course content based on the POPS pedagogical approach. Students were divided into learning groups and required to conduct systematic literature searches to gather relevant EBM evidence. Each group analyzed key aspects of representative clinical cases, including pathogenesis, clinical manifestations, and treatment protocols, ultimately formulating structured discussion outlines.\u003c/p\u003e\u003cp\u003eIn the course implementation phase, under the guidance of teachers, each learning group carried out case discussions based on the evidence-based evidence prepared in advance. Teachers conducted a comprehensive evaluation of students' clinical thinking ability, innovative consciousness and teamwork performance through formative assessment, and systematically sorted out the knowledge points at the end of the course. Meanwhile, a standardized questionnaire was adopted to evaluate the implementation effect of the EBM combined with POPS teaching method.\u003c/p\u003e\u003cp\u003eIn the after-class expansion phase: (1) Students should complete an immune-related review paper. (2)Students should be arranged to participate in clinical internships. By observing the diagnosis and treatment of actual cases and performing practical operations, students can enhance the integration of theoretical knowledge with clinical practice, thereby deepening their understanding and application ability in the field of allergy research and treatment.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eQuestionnaire\u003c/h3\u003e\n\u003cp\u003eThis study employed the Delphi expert consultation method to establish a teaching effectiveness evaluation index system for medical immunology courses. During the expert consultation process, a Likert scale was utilized to assess the importance of each indicator, with four rating levels: \"not important\" (1-point), \"moderately important\" (2-point), \"important\" (3-point), and \"very important\" (4-point). Nine experts with extensive experience in basic medical education participated in two rounds of consultation. Through systematic analysis and expert deliberation, a comprehensive multi-dimensional evaluation system was developed, consisting of 4 first-level indicators, 12 second-level indicators, and 31 third-level indicators. The first-level indicators included student response, learning outcomes, knowledge application, and overall impact. The second-level indicators encompassed understanding level, acceptance degree, participation level, satisfaction, theoretical knowledge mastery, clinical thinking development, learning attitude improvement, application depth, application scope, duration of effect, personal growth, and group benefits. Based on the expert consensus, a standardized teaching effect evaluation questionnaire was developed to evaluate and compare the application of evidence-based medicine combined with POPS teaching method and LBL teaching method in medical immunology teaching. The entire research process strictly adhered to the Delphi method protocol, and all expert suggestions were thoroughly discussed and incorporated into the final evaluation system.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eStatistical analysis was performed using the software SPSS 27.0. Continuous variables were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x̄\u0026plusmn;SD). Students\u0026rsquo; questionnaire data were analyzed using an independent t-test. Independent t-test was used to compare the acceptance and satisfaction of teaching methods, learning engagement, learning effectiveness, and long-term impact on students between the two groups. A p value of less than 0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 84 students were recruited in this study, including 33 males and 55 females, who were mainly second-year undergraduate students majoring in clinical or basic medicine. There were 14 males (41.2%) and 20 females (58.8%) in the LBL group. There were 19 males (35.2%) and 35 females (64.8%) in the EBM combined with POPS group. At the end of the course, an anonymous questionnaire survey was conducted to systematically evaluate the effect of LBL teaching and POPS teaching integrated with ebm in medical immunology. A 10-point visual analogue scale (VAS) was used to self-evaluate the teaching quality, with 0 indicating \"no effect\", 5 indicating \"moderate\", and 10 indicating \"completely perfect\". In addition to completing the questionnaires, participants from both groups were invited to provide suggestions for improving the two teaching methodologies.\u003c/p\u003e\u003cp\u003eThe questionnaire consisted of four modules with a total of 17 or 20 multiple-choice questions, covering the four dimensions of students' acceptance and satisfaction with teaching methods (6 questions, LBL group 3 questions), learning engagement (4 questions), learning effect (6 questions) and long-term impact (4 questions). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents survey data on student acceptance and satisfaction with teaching methods. Statistical analysis showed that compared with the LBL group, students in the EBM\u0026thinsp;+\u0026thinsp;POPS group had a higher evaluation of the teacher's teaching and the overall classroom (8.46\u0026thinsp;\u0026plusmn;\u0026thinsp;1.679 vs. 3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The close correlation between curriculum content and clinical practice was widely recognized (7.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.747 vs. 3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.070, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In addition, the questionnaire results also showed that students were more interested in EBM combined with POPS teaching method (8.42\u0026thinsp;\u0026plusmn;\u0026thinsp;1.643), and gave high scores for its applicability in courses such as Medical immunology (7.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.694). It was believed that this teaching method was helpful to deepen the thinking of career development than traditional teaching (7.74\u0026thinsp;\u0026plusmn;\u0026thinsp;1.835 vs. 2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.200, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStudents' acceptance and satisfaction with teaching methods.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLBL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEBM\u0026thinsp;+\u0026thinsp;POPS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou find the application of EBM combined with POPS in\u0026nbsp;Medical Immunology\u0026nbsp;teaching appropriate.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.909\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou find this teaching method more engaging than traditional lectures.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.42\u0026thinsp;\u0026plusmn;\u0026thinsp;1.643\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou are satisfied with the instructor\u0026rsquo;s teaching content and classroom organization.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e8.46\u0026thinsp;\u0026plusmn;\u0026thinsp;1.679\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17.946\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou believe the course content is closely integrated with clinical practice.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;1.070\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.747\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.230\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou feel the course has enhanced your reflection on career development.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.74\u0026thinsp;\u0026plusmn;\u0026thinsp;1.835\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15.287\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou support applying the EBM-POPS method in more courses.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.694\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe results of the survey on learning participation in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e show that the students in the group taught by EBM combined with POPS were significantly better than those in the LBL group on all the engagement indicators. The results showed that the frequency of students participating in class-related activities (group discussion/case analysis/knowledge exchange) for more than 3 times was significantly increased (7.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.848 vs. 2.53\u0026thinsp;\u0026plusmn;\u0026thinsp;1.107, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and the rate of completing homework before class and after class on time was significantly increased (7.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.696 vs. 3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.065, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In terms of classroom interaction, active response (6.54\u0026thinsp;\u0026plusmn;\u0026thinsp;1.723 vs. 2.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and teacher-student interaction frequency increased significantly; More importantly, the proportion of students in the EBM\u0026thinsp;+\u0026thinsp;POPS group who maintained their enthusiasm for learning was also significantly superior (6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.611 vs. 3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStudents' learning participation.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLBL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEBM\u0026thinsp;+\u0026thinsp;POPS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou actively participated in 3 or more immunology-related learning activities (such as group discussions, case analyses, knowledge exchanges, etc.).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.53\u0026thinsp;\u0026plusmn;\u0026thinsp;1.107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.848\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.245\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou completed pre-class preparations and assignments on time.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.696\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.803\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIn class, you frequently interacted with the instructor or answered questions.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.54\u0026thinsp;\u0026plusmn;\u0026thinsp;1.723\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou maintained enthusiasm during class.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;1.611\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.579\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the survey results on learning outcomes. Questionnaire analysis showed that the combination of EBM and POPS teaching method helped students systematically master the core theoretical knowledge of medical immunology (7.33\u0026thinsp;\u0026plusmn;\u0026thinsp;1.671 vs. 2.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.413, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The ability of students to analyze medical problems using immunological principles was significantly improved (7.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.868 vs. 3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.422, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The data of homework scores after class showed that this method helped to improve students' academic performance relative to the LBL group (7.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.774 vs. 3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.423, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Through continuous evidence-based information retrieval and literature review in POPS course, students' ability of literature retrieval and clinical evidence evaluation was effectively improved (6.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.714 vs. 2.97\u0026thinsp;\u0026plusmn;\u0026thinsp;1.507, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This teaching method can not only cultivate students' scientific research thinking (7.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.516 vs. 2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;1.403, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), but also stimulate students' interest in learning and enhance students' motivation for autonomous learning (7.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.573 vs. 2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.379, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eStudents' learning participation.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLBL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEBM\u0026thinsp;+\u0026thinsp;POPS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course helped you master core theoretical knowledge of\u0026nbsp;Medical Immunology.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.413\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.33\u0026thinsp;\u0026plusmn;\u0026thinsp;1.671\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course contributed to improving your exam performance.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.774\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.081\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYour ability to analyze medical issues using immunology knowledge has improved (such as allergy mechanisms, vaccine principles, etc.).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.09\u0026thinsp;\u0026plusmn;\u0026thinsp;1.422\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.41\u0026thinsp;\u0026plusmn;\u0026thinsp;1.868\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.259\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course enhanced your literature retrieval and clinical evidence evaluation skills.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.97\u0026thinsp;\u0026plusmn;\u0026thinsp;1.507\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e6.93\u0026thinsp;\u0026plusmn;\u0026thinsp;1.714\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11.360\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course increased your interest in learning and self-directed motivation.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.379\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.573\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14.151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course fostered your scientific research mindset.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;1.403\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.516\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.936\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe results of long-term evaluation of teaching effect in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e show that compared with the LBL teaching group, students receiving EBM combined with POPS teaching method showed significant advantages in multiple dimensions. Specifically, students in this group showed a more solid mastery of immunological knowledge (7.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.420 vs. 2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.379, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The medical professional identity was significantly enhanced through evidence-based teaching and case analysis (7.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.981 vs. 2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.525, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). More importantly, the vast majority of students expressed confidence in applying their immunology knowledge to clinical practice and research in the future (7.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.851 vs. 2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.443, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Moreover, the effect of EBM combined with POPS in improving students' professional competence was significant (7.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.039 vs. 2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.200, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating that the application of EBM combined with POPS had a continuous positive impact on students' professional development.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eLong-term impact on students.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eQuestion\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLBL\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEBM\u0026thinsp;+\u0026thinsp;POPS\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003et\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAfter the course, you retained some immunology knowledge.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.552\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.420\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.984\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYou are confident in applying immunology knowledge to future clinical or research problems.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.851\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e12.467\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course strengthened your professional identity in medicine.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.525\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.981\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e11.229\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThe course improved your job competency (clinical skills, research ability, teamwork, communication, career development, etc.).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e7.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.039\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13.192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAs one of the core courses in modern medical education system, medical immunology is of great significance to cultivate students' basic medical literacy and clinical thinking ability[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In recent years, EBM has been widely used in the field of medical education, which provides strong support for the innovation of teaching methods\u003csup\u003e[12\u0026ndash;15]\u003c/sup\u003e. At the same time, POPS teaching method has been widely promoted and applied in physiology, immunology and other basic medical courses due to its student-centered and practical ability training characteristics[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In addition, the combination of EBM and POPS has achieved remarkable results in postgraduate education of traditional Chinese medicine and clinical medicine, indicating that the application of this combination in other medical courses has broad development prospects. This study is the first time to apply EBM combined with POPS teaching method in medical immunology teaching, which is novel. The teaching effect was evaluated by standardized questionnaire survey, quizzes after class and the completion of students' review. The results of the study showed that this teaching method was significantly better than the traditional LBL teaching method in multiple dimensions.\u003c/p\u003e\u003cp\u003eIn the process of constructing the evaluation index system of teaching effect of medical immunology course, we referred to the opinions of expert consultation before class. It is gratifying to note that nine experts were generally satisfied with the EBM combined with POPS teaching method. These experts are excellent teachers with rich teaching experience, and they agree with and are satisfied with our teaching method, mainly for the following reasons: first, teachers can observe that students actively participate in learning in the classroom, showing a high level of participation and enthusiasm. Secondly, students are able to understand and apply relevant knowledge, propose reasonable solutions, and demonstrate learning outcomes during the process of literature search and clinical evidence evaluation. In addition, students were able to collaborate, communicate, and coordinate effectively within groups to solve case problems together. Teachers gave positive comments on the promotion of EBM combined with POPS teaching method. The previous literature search strengthened their confidence in the application of this teaching method in medical education courses. This teaching method not only has a positive effect on the personal growth of teachers, but also provides useful thinking for the construction of high-quality courses and the cultivation of medical talents with core competitiveness.\u003c/p\u003e\u003cp\u003eAccording to the results of the students' feedback questionnaire after class, the teaching method of EBM combined with POPS scored significantly higher than the traditional teaching method in terms of students' acceptance and satisfaction, learning engagement, learning effect and long-term influence on students. To be specific: first of all, case-oriented course content and student-centered classroom organization are more easily accepted by students. The EBM philosophy, which runs through it, enables students to further integrate theory with clinical practice, thereby increasing their thinking about their future career development. Secondly, EBM combined with POPS teaching method can significantly enhance classroom interaction and promote active communication and collaboration between students. This interaction not only improved learning efficiency, but also stimulated students' enthusiasm for learning and made them more active to participate in the evidence-based investigation before class and review consolidation after class. Through literature review, group cooperation and class discussion before class, students deepened their understanding and application of knowledge, and further consolidated their learning results. In addition, this teaching method also cultivated students' independent learning ability and helped them better grasp the core theoretical knowledge of medical immunology. Students can actively explore and expand their knowledge field, and improve their ability to solve medical problems with immunology knowledge. The teaching model based on clinical cases, combined with extensive literature review, not only cultivates students' clinical thinking and scientific research thinking, but also improves their ability to evaluate clinical evidence. Finally, compared with the traditional passive learning method, the EBM combined with POPS teaching method puts more emphasis on the active participation and autonomous learning of students, making the learning process more interesting and stimulating. This teaching method has had a profound long-term impact on students. Even after the course, students can still remember some immunological knowledge and apply it to clinical practice and scientific research in the future, so as to consolidate their learning results and improve their competency.\u003c/p\u003e\u003cp\u003eTo more accurately assess long-term learning outcomes, we not only conducted a theoretical test after the course, but also asked students to submit a review of the immunology course. In the theory examination, students in the EBM combined with POPS group achieved higher scores. This may be because the teaching method of EBM combined with POPS emphasizes active learning and active participation of students, enabling them to understand the topic more deeply through group discussions and case analysis in class. This deep understanding helps students to better apply and express what they have learned in theoretical examinations, thus achieving better results. For review writing, students in the EBM combined POPS group achieved higher scores for literature review and citation, arguments and opinions, content integrity, scientific rigor, and accuracy. The results showed that the combination of EBM and POPS teaching method had a significant effect on the cultivation of students' scientific research thinking. Through extensive literature search and evidence-based medicine evidence evaluation, this group of students formed a comprehensive and systematic cognition of disease-related knowledge, so as to provide more powerful reference and support in the review papers[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. In addition, the EBM combined with POPS teaching method focused on the cultivation of students' self-directed learning ability. Through group collaboration and discussion, students are encouraged to think deeply and analyze problems, so that they can actively explore and articulate more convincing arguments in their thesis writing. Compared with the traditional teaching group, the students in the EBM combined with POPS group showed higher integrity in their papers, demonstrating scientific rigor and accuracy. Therefore, this teaching method can effectively cultivate students' ability of literature retrieval and clinical evidence evaluation, and lay a solid foundation for the long-term development of students' scientific research and clinical career.\u003c/p\u003e\u003cp\u003eHowever, there are some limitations to our study. (1) There may be selection bias, because our sample is mainly from the sophomore majoring in basic medicine and clinical medicine, who are still in the stage of college learning, have not yet been fully exposed to clinical practice, and have limited improvement in clinical practice skills. (2) Since the two groups of students are taught by different teachers, the difference of teachers' personal styles may have an impact on the teaching quality, which is difficult to completely eliminate. (3) The results of the study may be affected by the subjective factors of the participants. Student academic performance and paper quality may be influenced by individual differences, learning motivation, and learning styles, and although attempts have been made to control for these factors in research designs, there is still some difficulty in completely eliminating their influence.\u003c/p\u003e\u003cp\u003eIn conclusion, EBM combined with POPS is an efficient teaching method that has achieved significant improvements in several aspects compared to the traditional teaching model. Through group learning and collaboration, this model can effectively promote classroom interaction, significantly improve learning efficiency, knowledge acquisition ability, autonomous learning ability and team cooperation ability. In addition, the teaching model of EBM combined with POPS focuses on cultivating students' clinical thinking and scientific research thinking, which helps students to understand and apply medical theoretical knowledge more deeply. Therefore, this teaching model provides a useful reference for the course construction under the background of modern medical education, and contributes an important force to the cultivation of high-quality medical talents[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Future studies can further expand the sample size, cover more students in grade and professional background, and try to control for factors such as differences in teachers' personal styles to more fully verify the effectiveness and universality of EBM combined with POPS teaching method.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eEBM \u0026nbsp; \u0026nbsp; evidence-based medicine\u003c/p\u003e\n\u003cp\u003ePOPS \u0026nbsp; \u0026nbsp; problem-oriented patient solving\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was performed in accordance with the Helsinki Declaration. Students were free to opt out of the study. The questionnaire is anonymous to protect student privacy. Participation did not impact students’ evaluations. The informed consent obtained from study participants was written.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo potential conflict of interest was reported by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChongqing postgraduate education and teaching reform postgraduate project [YJG233144)] and research project on educational reform of army medical university [2024B01].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSZJ drafted the manuscript. SZJ, YH and LGQ took primary responsibility for questionnaire design, distribution, data collection, and collation. HX, DBS and YCY, XZY contributed to curriculum design. WYZ, GS and CJ initiated the project and developed the research framework.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank Anne Basye for her editing contributions to the first draft of the manuscript, and the expert reviewers for their input on the survey development.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJiang Z, Jiang W, Media Integration and Mass Communication Department, China Population Communication Center, Beijing, China. Health education in the healthy china initiative 2019\u0026minus;2030. China CDC Wkly. 2021;3(4):78\u0026ndash;80. \u003c/li\u003e\n\u003cli\u003eYang C, Chen Y, Qian C, Shi F, Guo Y. The data-intensive research paradigm: challenges and responses in clinical professional graduate education. Front Med. 2025 Feb 7;12:1461863. \u003c/li\u003e\n\u003cli\u003eLi Y, Li J, Li B, Cao Y, Liu M, Zhang L, Zeng Z. Factors associated with the research efficiency of clinical specialties in a research-oriented hospital in China. Xue B, editor. PLOS One. 2021 Apr 28;16(4):e0250577. \u003c/li\u003e\n\u003cli\u003eFu DQ, Huang YQ, Que YH, Hong Y, Lin JQ. Factors affecting the scientific research ability and the corresponding countermeasures in clinical postgraduates. BMC Med Educ. 2023 May 5;23(1):309. \u003c/li\u003e\n\u003cli\u003eVogt M, Schuchardt N, Geissler ME, Bereuter JP, Geissler RB, Glauche I, Gerdes S, Deu\u0026szlig;en A, G\u0026uuml;nther L. Scientific competence during medical education - insights from a cross-sectional study at a german medical school. BMC Med Educ. 2024 May 28;24(1):590. \u003c/li\u003e\n\u003cli\u003eHaidaris CG, Frelinger JG. Inoculating a new generation: immunology in medical education. Front Immunol. 2019 Nov 1;10:2548. \u003c/li\u003e\n\u003cli\u003eArmson AJ, Meyer AJ, Losco BE, Ardakani EM, Walker BF. Immunology knowledge as one of the basic sciences that forms the foundations to developing sound clinicians. J Chiropr Educ. 2016 Oct;30(2):108\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eUlfa Y, Igarashi Y, Takahata K, Shishido E, Horiuchi S. A comparison of team-based learning and lecture-based learning on clinical reasoning and classroom engagement: a cluster randomized controlled trial. BMC Med Educ. 2021 Dec;21(1):444. \u003c/li\u003e\n\u003cli\u003eZhang Q, Tang X, Zhao Y, Wang Z. Team-based learning vs. lecture-based learning in nursing: a systematic review of randomized controlled trials. Front Public Health. 2023 Jan 4;10:1044014. \u003c/li\u003e\n\u003cli\u003eLee GB, Chiu AM. Assessment and feedback methods in competency-based medical education. Ann Allergy Asthma Immunol. 2022 Mar;128(3):256\u0026ndash;62. \u003c/li\u003e\n\u003cli\u003eHuang T, Zhou S, Wei Q, Ding C. Team-, case-, lecture- and evidence-based learning in medical postgraduates training. BMC Med Educ. 2024 Jun 18;24(1):675. \u003c/li\u003e\n\u003cli\u003eChandran VP, Balakrishnan A, Rashid M, Khan S, Devi ES, Kulyadi GP, Nair S, Thunga G. Teaching and learning strategies of evidence based medicine: a meta-synthesis of learners and instructors perspective. Clin Epidemiol Glob Health. 2023 May;21:101280. \u003c/li\u003e\n\u003cli\u003eThomas A, Chin-Yee B, Mercuri M. Thirty years of teaching evidence-based medicine: have we been getting it all wrong? Adv Health Sci Educ. 2022 Mar;27(1):263\u0026ndash;76. \u003c/li\u003e\n\u003cli\u003eMaggio LA. Educating physicians in evidence based medicine: current practices and curricular strategies. Perspect Med Educ. 2016 Oct 25;5(6):358\u0026ndash;61. \u003c/li\u003e\n\u003cli\u003eGuyatt G. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA. 1992 Nov 4;268(17):2420. \u003c/li\u003e\n\u003cli\u003eIlic D, Hart W, Fiddes P, Misso M, Villanueva E. Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study. BMC Med Educ. 2013 Dec;13(1):169. \u003c/li\u003e\n\u003cli\u003eWyer PC. Evidence-based medicine and problem based learning a critical re-evaluation. Adv Health Sci Educ. 2019 Dec;24(5):865\u0026ndash;78. \u003c/li\u003e\n\u003cli\u003eSmith N. Evidence-based practice in medical education: team-based learning in a blended curriculum [Internet]. Medical Education; 2024 [cited 2025 May 21]. Available from: http://medrxiv.org/lookup/doi/10.1101/2024.06.25.24309485\u003c/li\u003e\n\u003cli\u003eSingh A. Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures. Adv Med Educ Pract. 2010 Dec;9. \u003c/li\u003e\n\u003cli\u003eZhang Z, Liu W, Han J, Guo S, Wu Y. A trial of patient-oriented problem-solving system for immunology teaching in China: a comparison with dialectic lectures. BMC Medical Education. 2013 Jan 28;13:11. \u003c/li\u003e\n\u003cli\u003eMohan BS, Nambiar V, Arvindkshan R. Patient-oriented Problem-solving: An Effective Educational Tool for Learning Immunology. Int Jour of Dent and Med Spec. 2017;4(1):2. \u003c/li\u003e\n\u003cli\u003eDesai KN, Satapara VK, Rathod GB, Maru AM. Development and evaluation of the POPBL (patient-oriented problem-based learning) module in pathology: a comparative analysis of performance and perception among second-year pathology students. Cureus [Internet]. 2022 Sep 7 [cited 2025 May 21]; Available from: https://www.cureus.com/articles/109734-development-and-evaluation-of-the-popbl-patient-oriented-problem-based-learning-module-in-pathology-a-comparative-analysis-of-performance-and-perception-among-second-year-pathology-students\u003c/li\u003e\n\u003cli\u003eMenard L, Blevins AE, Trujillo DJ, Lazarus KH. Integrating evidence-based medicine skills into a medical school curriculum: a quantitative outcomes assessment. BMJ Evid-based Med. 2021 Oct;26(5):249\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eWang C, Yao Y, Chen Y, Chen J. The impact of evidence-based medicine curricula on information literacy among clinical medical undergraduates and postgraduates in China. BMC Medical Education. 2025 Apr 11;25(1):520. \u003c/li\u003e\n\u003cli\u003eTan X, Liu X, Shao H. Healthy china 2030: a vision for health care. Value Health Reg Issues. 2017 May;12:112\u0026ndash;4. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Evidence-based medicine, Problem-oriented patient solving, Medical immunology, Teaching practice, Questionnaire survey","lastPublishedDoi":"10.21203/rs.3.rs-7600082/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7600082/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eMedical immunology is a core course in modern medical education, playing a crucial role in cultivating students' medical literacy and clinical thinking abilities. In recent years, the Evidence-based medicine (EBM) and Problem-oriented patient solving (POPS) teaching methods have been widely applied in medical education and have achieved remarkable outcomes in graduate education in Traditional Chinese Medicine and clinical medicine. However, the application of the EBM combined with POPS teaching method in medical immunology courses remains underexplored.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis study aims to investigate the application effect of the EBM combined with POPS teaching method in medical immunology courses, to provide a reference for a novel teaching model and contribute to the cultivation of high-quality medical talents through the teaching of medical immunology.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis study is the first to apply the EBM combined with POPS teaching method in medical immunology courses. The teaching effectiveness was evaluated through standardized questionnaires, post-class tests, and students' feedback. Additionally, the teaching effect evaluation index system was constructed based on expert consultations. The overall teaching effectiveness of this method was comprehensively analyzed by combining students' feedback questionnaires, theoretical test results, and course review writing.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe EBM combined with POPS teaching method significantly outperforms traditional teaching methods in enhancing student learning participation, knowledge acquisition, autonomous learning ability, and team cooperation skills. This method effectively promotes classroom interaction and fosters students' clinical and scientific research thinking, providing a valuable reference for the development of medical education courses.\u003c/p\u003e","manuscriptTitle":"Evidence-based medicine combined with patient-oriented problem-solving teaching method: an effective tool for learning medical immunology","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-17 12:25:13","doi":"10.21203/rs.3.rs-7600082/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6995ac8a-7e85-416b-be2b-490e43cd282a","owner":[],"postedDate":"October 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-01-13T05:23:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-17 12:25:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7600082","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7600082","identity":"rs-7600082","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}