Objective  To explore the effectiveness of blended learning in clinical medicine teaching in China using Meta-analysis, so as to provide a reference for cultivating clinical medical talents and improving the quality of medical education. 

Methods  PubMed, CNKI, WanFang Data, and SinoMed databases were searched for studies investigating blended learning in clinical medicine teaching. Literature screening, data extraction and quality assessment were independently conducted by two researchers. Meta-analysis was performed using Stata12.0 software. Heterogeneity was evaluated by subgroup analyses, and sensitivity analysis was performed to detect the influence of any single study on the overall prevalence estimates. 

Results  A total of 66 studies were included with significant between-study heterogeneity. The results of a Meta-analysis based on a random-effects model showed that blended learning had a significantly better positive effect size on theoretical knowledge [SMD=1.73, 95%CI(1.32, 2.15), P<0.05], practical/operational skills [SMD=1.28, 95%CI(0.81, 1.75), P<0.05] and satisfaction rating [RR=1.35, 95%CI(1.23, 1.49), P<0.05] than traditional learning. There was no significant difference found in theoretical knowledge and practical/operational skills among students with different educational levels. Blended learning showed significantly better outcomes for both theoretical knowledge [SMD=1.79, 95%CI(1.27, 2.31), P<0.001], and practical/operational skills [SMD=1.62, 95%CI(1.12, 2.13), P<0.001] among undergraduate students. Blended learning was found to have a positive effect on theoretical knowledge [SMD=1.28, 95%CI(0.60, 1.96), P<0.001] compared with traditional learning in junior college students, however, this effect was not observed in their practical/operational skills. 

Conclusion  Compared with traditional learning, blended learning was shown to have a better effect on theoretical knowledge and practical/operational skills, and higher satisfaction ranking among clinical medical students in China, suggesting that more attention should be given to the advantages of blended learning and this could help the reform of medical education and the cultivation of clinical medical talents.

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