Enhancing Cognitive, Performance Skills, and Affective Competencies through Case-Based Learning among Midwifery Students: A Scoping Review

Authors

  • Jelsita Nova Universitas Padjadjaran
  • Ari Indra Susanti Universitas Padjadjaran

DOI:

https://doi.org/10.58706/jipp.v4n2.p162-175

Keywords:

Case-Based Learning (CBL), Midwifery Education, Clinical Competence, Critical Thinking, Student Motivation

Abstract

Midwifery students are expected to develop good clinical competencies to ensure the delivery of safe, effective, and holistic maternal care. However, conventional learning methods often fall short in cultivating critical thinking, clinical reasoning, and decision-making skills. Case-Based Learning (CBL) has emerged as a student-centered pedagogical strategy that bridges the gap between theory and clinical practice. This study aims to map the forms of CBL implementation in midwifery education, particularly in enhancing students’ competencies in cognitive, performance skills, motivational, and collaborative domains, while also highlighting contextual limitations in its application. This scoping review adopted the PRISMA-ScR framework and conducted searches across PubMed, ScienceDirect, and Google Scholar. Eligible articles were published between 2020 and 2025, written in English, and presented original full-text research. Out of 655 initially retrieved records, 12 studies met the inclusion criteria after title, abstract, and full-text screening. Findings show that CBL positively contributes to the development of midwifery students’ cognitive competencies, including critical thinking, knowledge retention, and clinical reasoning, as reported in the majority of studies. Improvements in performance skills, such as decision-making and practical readiness, were also noted, particularly when CBL was supported with technology like video-based scenarios and virtual reality. Additionally, CBL fostered student engagement, motivation, and collaboration, although one study reported limited enthusiasm due to contextual factors such as passive delivery. In conclusion, CBL is an effective pedagogical approach for developing cognitive, performance skills, and affective competencies in midwifery students. To optimize its impact, educators should integrate CBL with interactive digital tools such as simulation and virtual reality. These innovations enhance engagement and provide immersive learning experiences that align with the demands of reflective, hands-on maternal care. The findings of this review have important implications for midwifery education, particularly in supporting the adoption of more student-centered and clinically oriented teaching strategies to strengthen students’ competence and readiness for professional practice. Further research is needed to standardize CBL implementation and explore its long-term outcomes across diverse learning environments.

References

Al-Bedaery, R., Baig, S., Khare, Y., and Sullivan-Mchale, J. (2024). Humanising case-based learning. Medical Teacher, 46(10), 1348–1355. DOI: https://doi.org/10.1080/0142159X.2024.2308066.

Bahrami-Vazir, E., Azadi, A., Sharifi, N., Khodabandeh, F., Otaghi, M., and Mohammadi, A. (2023). Impact of case study-based teaching on academic enthusiasm of midwifery students toward ectopic pregnancy: A cross-sectional study. Journal of Medical Education Development, 16(51), 32–37. DOI: https://doi.org/10.32592/jmed.2023.16.51.32.

Beecher, C., Devane, D., White, M., Greene, R., and Dowling, M. (2019). Concept development in Nursing and Midwifery: an overview of methodological approaches. International Journal of Nursing Practice, 25(1), e12702. DOI: https://doi.org/https://doi.org/10.1111/ijn.12702.

Burgess, A., Matar, E., Roberts, C., and Mellis, C. (2021). Scaffolding medical student knowledge and skills: Team-based learning (TBL) and case-based learning (CBL). BMC Medical Education, 32, 238. DOI: https://doi.org/10.1186/s12909-021-02638-3.

Cen, X.Y., Hua, Y., Niu, S., and Yu, T. (2021). Application of case-based learning in medical student education: a meta-analysis. European Review for Medical and Pharmacological Sciences, 25(8), 3173-31811. DOI: https://doi.org/10.26355/eurrev_202104_25726.

Chigerwe, M., Boudreaux, K.A., and Ilkiw, J.E. (2017). Self-directed learning in veterinary medicine: are the students ready? International Journal of Medical Education, 8, 229–230. DOI: https://doi.org/10.5116/ijme.5929.402f.

Dong, H., Guo, C., Zhou, L., Zhao, J., Wu, X., Zhang, X., and Zhang, X. (2022). Effectiveness of case-based learning in Chinese dental education: a systematic review and meta-analysis. BMJ Open, 12(2), e048497. DOI: https://doi.org/10.1136/bmjopen-2020-048497.

Donkin, R., Yule, H., and Fyfe, T. (2023). Online case-based learning in medical education: a scoping review. BMC Medical Education, 23(1), 564. DOI: https://doi.org/10.1186/s12909-023-04520-w.

Gholami, M., Saki, M., Toulabi, T., Moghadam, P.K., Pour, A.H.H., and Dostizadeh, R. (2017). Iranian nursing students’ experiences of case-based learning: A qualitative study. Journal of Professional Nursing, 33(3), 241–249. DOI: https://doi.org/10.1016/j.profnurs.2016.08.013.

Ha, H. and Lopez, T. (2014). Developing health literacy knowledge and skills through case-based learning. American Journal of Pharmaceutical Education, 78(1), 17. DOI: https://doi.org/10.5688/ajpe78117.

Halida, E.M. and Oktova, R. (2022). Application of case-based method in postpartum pre-profession courses to improve student learning outcomes. Proceedings of the 4th International Conference on Educational Development and Quality Assurance (ICED-QA 2021), 149–152. DOI: https://doi.org/10.2991/assehr.k.220303.028.

Hopper, M. (2018). Alphabet soup of active learning: Comparison of PBL, CBL, and TBL. HAPS Educator, 22(2), 144–149. DOI: https://doi.org/10.21692/haps.2018.019.

Hristova, T., Todorova, T., and Markova, M. (2021). Using case study method for forming clinical thinking ability in nursing and midwifery education. TEM Journal, 10(1), 471–475. DOI: https://doi.org/10.18421/TEM101-59.

Iffah, U. and Hudzaifah, H.M. (2022). Application of case-based method in pre-professional family planning course to improve the critical thinking of students of midwifery study program at Andalas University. Proceedings of the 4th International Conference on Educational Development and Quality Assurance (ICED-QA 2021), 169–173. DOI: https://doi.org/10.2991/assehr.k.220303.033.

Jacob, S.A., Dhing, O.H., and Malone, D. (2019). Perceptions of Australian and Malaysian educators in an undergraduate pharmacy program on case-based learning. American Journal of Pharmaceutical Education, 83(3), 401–411. DOI: https://doi.org/10.5688/ajpe6597.

Katebi, S., Leilimosalanejad, and Bazrafkan, L. (2020). Development of midwifery emergency curriculum by the clinical case-based crossword games simulation and learning in midwifery students. Pakistan Journal of Medical and Health Sciences, 14(3), 1126–1130. Retrieved from: https://pjmhsonline.com/2020/july-sep/1126.pdf.

Khattak, O., Alruwaili, N.G., Alarjan, L.M.M., Alsattam, A.A., Anis, R., Iqbal, A., and Chaudhary, F.A. (2024). Evaluating case-based learning to enhance dental student performance in cavity preparation: A pilot study. Cureus, 16(9), e69222. DOI: https://doi.org/10.7759/cureus.69222.

Kolaski, K., Logan, L.R., and Ioannidis, J.P.A. (2023). Guidance to best tools and practices for systematic reviews. JBI Evidence Synthesis, 21(9), 1699–1731. DOI: https://doi.org/10.11124/JBIES-23-00139.

Lestari, E., Rahmawatie, D.A., and Wulandari, C.L. (2023). Does online interprofessional case-based learning facilitate collaborative knowledge construction? Journal of Multidisciplinary Healthcare, 16(January), 85–99. DOI: https://doi.org/10.2147/JMDH.S391997.

Lisa, U.F. and Wijayanti, F.A. (2023). Case-based learning video and learning motivation among midwifery students. Embrio, 15(1), 75–82. DOI: https://doi.org/10.36456/embrio.v15i1.6817.

Liu, A., Zhou, L.L., Lam, A., and Dahlke, E. (2018). Case-based learning in dermatology. Journal of Cutaneous Medicine and Surgery, 22(3), 273–279. DOI: https://doi.org/10.1177/1203475417752368.

McLean, S.F. (2016). Case-based learning and its application in medical and health-care fields: A review of worldwide literature. Journal of Medical Education and Curricular Development, 3, 39–49. DOI: https://doi.org/10.4137/jmecd.s20377.

Muthukrishnan, S.P., Chandran, D.S., Afreen, N., Bir, M., Dastidar, S.G., Jayappa, H., Mattoo, B., Navneet, A., Poorasamy, J., Roy, A., Sharma, A., Ghosh, D., and Deepak, K.K. (2019). Planning, implementation, and evaluation of multicomponent, case-based learning for first-year Indian medical undergraduates. Advances in Physiology Education, 43(4), 504–511. DOI: https://doi.org/10.1152/advan.00080.2019.

Nove, A., Friberg, I.K., de Bernis, L., McConville, F., Moran, A.C., and Najjemba, M. (2021). Potential impact of midwives in preventing and reducing maternal and neonatal mortality and stillbirths: A lives saved tool modelling study. The Lancet Global Health, 9(1), e24–e32. DOI: https://doi.org/10.1016/S2214-109X(20)30397-1.

Nunohara, K., Imafuku, R., Saiki, T., Bridges, S. M., Kawakami, C., Tsunekawa, K., Niwa, M., Fujisaki, K., and Suzuki, Y. (2020). How does video case-based learning influence clinical decision-making by midwifery students? An exploratory study. BMC Medical Education, 20(1), 67. DOI: https://doi.org/10.1186/s12909-020-1969-0.

Pinto, B.L. (2022). Distinguishing between case based and problem based learning. International Journal of Kinesiology in Higher Education, 7(3), 246–256. DOI: https://doi.org/10.1080/24711616.2022.2111286.

Ridley, N. and Byrom, A. (2018). Developing a case based learning curriculum with a salutogenic perspective. Midwifery, 64, 124–127. DOI: https://doi.org/10.1016/j.midw.2018.06.006.

Safaringga, M. and Fitrayeni, F. (2022). Development and Implementation of Case Based Methods in Block 3A. Midwife Care on Pregnancy at the Undergraduate of Midwifery Program Faculty of Medicine Andalas University in 2021. Proceedings of the 4th International Conference on Educational Development and Quality Assurance (ICED-QA 2021), 383–388. DOI: https://doi.org/10.2991/assehr.k.220303.069.

Shafique, A., Rehman, A.U., Ibnerasa, S., Glanville, R., and Ali, K. (2024). Case-based learning in undergraduate orthodontic education: A cross sectional study. MedEdPublish, 14, 29. DOI: https://doi.org/10.12688/mep.20096.2.

Thistlethwaite, J.E., Davies, D., Ekeocha, S., Kidd, J.M., MacDougall, C., Matthews, P., Purkis, J., and Clay, D. (2012). The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23. Medical Teacher, 34(6), e421–e444. DOI: https://doi.org/10.3109/0142159X.2012.680939.

Tricco, A.C., Lillie, E., Zarin, W., O’Brien, K.K., Colquhoun, H., Levac, D., Moher, D., Peters, M.D.J., Horsley, T., Weeks, L., Hempel, S., Akl, E.A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M.G., Garritty, C., Lewin, S., Godfrey, C.M., Macdonald, M.T., Langlois, E.V., Soares-Weiser, K., Moriarty, J., Clifford, T., Tuncalp, O, and Straus, S.E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467-473. DOI: https://doi.org/10.7326/m18-0850.

Varma, B., Karuveettil, V., Fernandez, R., Halcomb, E., Rolls, K., Kumar, S.V., and Aravind, M.S. (2025). Effectiveness of case-based learning in comparison to alternate learning methods on learning competencies and student satisfaction among healthcare professional students: A systematic review. Journal of Education and Health Promotion, 14(1), 76. DOI: https://doi.org/10.4103/jehp.jehp_510_24.

Virahaju, M.V. and Ekawati, D. (2023). The use of case based learning in anatomy physiology for first year midwifery students. Proceedings of the 2022 ‘Aisyiyah International Conference on Health and Medical Sciences (A-HMS 2022), 19-22. DOI: https://doi.org/10.2991/978-94-6463-190-6_4.

Westerdahl, F., Carlson, E., Wennick, A., and Borglin, G. (2022). Bachelor nursing students’ and their educators’ experiences of teaching strategies targeting critical thinking: A scoping review. Nurse Education in Practice, 63, 103409. DOI: https://doi.org/10.1016/j.nepr.2022.103409.

World Health Organization. (2019). Strengthening quality midwifery education for Universal Health Coverage 2030: Framework for action. Switzerland: WHO. Retrieved from: https://iris.who.int/bitstream/handle/10665/324738/9789241515849-eng.pdf?sequence=1.

Wu, F., Wang, T., Yin, D., Xu, X., Jin, C., Mu, N., and Tan, Q. (2023). Application of case-based learning in psychology teaching: a meta-analysis. BMC Medical Education, 23(1), 609. DOI: https://doi.org/10.1186/s12909-023-04525-5.

Yang, W., Zhang, X., Chen, X., Lu, J., and Tian, F. (2024). Based case based learning and flipped classroom as a means to improve international students’ active learning and critical thinking ability. BMC Medical Education, 24(1), 759. DOI: https://doi.org/https://doi.org/10.1186/s12909-024-05758-8.

Yao, J., Yuan, H., Zhu, M., Wang, J., Wang, Q., Chen, Z., Chen, Y., and Zhang, X. (2023). Nursing student learning of evidence-based nursing through case-based learning and flipped learning: A mixed study. Nursing Open, 10(9), 6551–6558. DOI: https://doi.org/10.1002/nop2.1910.

Yoo, M.S. and Park, H.R. (2015). Effects of case-based learning on communication skills, problem-solving ability, and learning motivation in nursing students. Nursing and Health Sciences, 17(2), 166–172. DOI: https://doi.org/10.1111/nhs.12151.

Zhang, Y., Xu, X., Wang, F., Tu, L., Deng, Q., Xu, M., He, G., Johnston, L., and Bloomberg, L.S. (2024). The use of bedside case-based learning in the clinical practice of midwifery education in China. BMC Medical Education, 24, 1308. DOI: https://doi.org/10.1186/s12909-024-06251-y.

Zhao, L., Dai, X., and Chen, S. (2024). Effect of the case-based learning method combined with virtual reality simulation technology on midwifery laboratory courses: A quasi-experimental study. International Journal of Nursing Sciences, 11(1), 76–82. DOI: https://doi.org/10.1016/j.ijnss.2023.12.009.

Zhao, W., He, L., Deng, W., Zhu, J., Su, A., and Zhang, Y. (2020). The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Medical Education, 20(1), 381. DOI: https://doi.org/10.1186/s12909-020-02306-y.

Downloads

Published

26-04-2026

How to Cite

Nova, J., & Susanti, A. I. (2026). Enhancing Cognitive, Performance Skills, and Affective Competencies through Case-Based Learning among Midwifery Students: A Scoping Review. Jurnal Ilmu Pendidikan Dan Pembelajaran, 4(2), 162–175. https://doi.org/10.58706/jipp.v4n2.p162-175

Issue

Section

Articles