Systematic review shows very low certainty that mind mapping improves exam scores over lecture-based learning in Chinese residents
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Key Takeaway
Note very low certainty that mind mapping improves exam scores over lecture-based learning in Chinese residents.
This systematic review and meta-analysis examined the efficacy of mind mapping compared to lecture-based learning within China's standardized residency training program. The analysis included 3,312 participants, with 1,698 in the mind mapping group and 1,614 in the lecture-based learning group. Outcomes assessed included examination scores in theoretical knowledge, case analysis, procedural skill, satisfaction, learning motivation, and other secondary measures.
The meta-analysis reported significantly higher examination scores for the mind mapping group across theoretical knowledge, case analysis, and procedural skill. Standardized mean differences were 1.45 for theoretical knowledge, 1.34 for case analysis, and 1.68 for procedural skill. The 95% confidence intervals for these effects were 1.16 to 1.74, 0.95 to 1.72, and 1.23 to 2.13 respectively.
However, the overall certainty of evidence was very low. Limitations included a lack of allocation concealment and blinding in 98% of included studies. High heterogeneity, defined as I2 greater than 80%, was present in 11 out of 12 meta-analyses using continuous data. Safety data, adverse events, and discontinuations were not reported.
The authors conclude that current evidence is insufficient for strong practice recommendations. Clinicians should interpret these results with caution given the very low certainty and significant methodological limitations inherent in the included studies.
View Original Abstract ↓
BackgroundMind mapping has been widely used as an intervention in medical education of China’s standardized residents training (SRT) program. Our study aims to investigate the effectiveness of mind mapping compared with lecture-based learning (LBL) in China’s SRT.MethodsA PRISMA guideline based systemic review and meta-analysis (PROSPERO registration number: CRD420251244861) was performed. We searched the publications in PubMed, China National Knowledge Infrastructure, VIP database and Wanfang database up to December 24, 2025 to identify randomized controlled studies with outcomes measure from mind mapping and LBL. Two independent reviewers performed the study selection, data extraction and quality assessment. All the statistical analyses were performed by R 4.1.1 software.ResultsA total of 52 studies with 3,312 participants (Mind mapping group = 1,698, LBL group = 1,614) were selected in our meta-analysis. These studies published from 2017 to 2025. Meta-analysis identified significantly higher examination scores in mind mapping group compared to LBL group in theoretical knowledge (SMD = 1.45, 95% CI: 1.16–1.74), case analysis (SMD = 1.34, 95% CI: 0.95–1.72), and procedural skill (SMD = 1.68, 95% CI: 1.23–2.13). Questionnaire surveys results showed that residents were more satisfied with the mind mapping and had improvements in level of theoretical knowledge, learning motivation, problem-solving ability, proficiency in literature retrieval, clinical skills, and teamwork. There were 98% of the included studies lacked allocation concealment and blinding, and high heterogeneity (I2 > 80%) was present in 11 out of 12 meta-analyses using continuous data. GRADE assessment showed that the overall certainty of evidence was very low.ConclusionOur meta-analysis indicates that mind mapping is potentially more effective than LBL in medical education of China’s SRT system. Given the limitations of substantial heterogeneity and very low certainty evidence, our findings are insufficient for strong practice recommendations. Further well-designed studies are required to confirm our findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251244861.
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