# Efficacy of an integrated case-based learning and team-based learning model within the subjective, objective, assessment, and plan framework in physical therapy education

## TL;DR

This study shows that combining case-based and team-based learning with the SOAP framework improves student engagement and clinical reasoning in physical therapy education.

## Contribution

The novel integration of case-based learning and team-based learning within the SOAP framework is shown to enhance clinical reasoning and collaboration in PT education.

## Key findings

- Students using CBL+TBL with the SOAP framework scored significantly higher in self-assessment, self-directed learning, and group cooperation.
- The CBL+TBL group showed better class and practical performance compared to traditional teaching methods.
- The model improved learning satisfaction and clinical reasoning without affecting overall academic grades.

## Abstract

Conventional “lecture+demonstration” pedagogy in physical therapy (PT) education frequently constrains student engagement and the evolution of clinical reasoning. The Physical Therapy for Orthopedic Diseases (PTOD) course necessitates strong clinical reasoning and collaboration, which the mixed approach of case-based learning (CBL) and team-based learning (TBL), along with the SOAP framework, aims to improve.

This study employed a quasi-experimental design to analyze data collected from Guangzhou Medical University (GZMU) between March 2023 and June 2024. A total of 46 third-year physiotherapy students (2020 cohort: n = 25, CBL + TBL; 2021 cohort: n = 21, traditional teaching) completed the study. Baseline comparability between the two groups was ensured by comparing routinely collected academic performance data and questionnaire responses obtained prior to the start of the course. The 2020 cohort had participated in role-shifting SOAP activities using actual cases, whereas the 2021 cohort had received lecture-based teaching accompanied by SOAP framework. Outcomes included questionnaire scores (Self-assessment, Self-directed learning, Group-cooperation, Teacher-assessment, Learning-effectiveness, Learning-satisfaction) and academic performance (class performance, practical performance, theoretical scores) were analyzed.

The 2020 cohort markedly outperformed the 2021 cohort in total scores of questionnaires (p < 0.001) and in the sub-dimensions of Self-assessment (p < 0.01), Self-directed learning (p < 0.05), Group cooperation (p < 0.001), and Learning satisfaction (p < 0.05). In the 2020 cohort, pre-post enhancements were statistically significant in total scores (p < 0.001) and the corresponding sub-dimensions (p < 0.001). The 2021 cohort exhibited a notable reduction in group cooperation (p < 0.05). Overall grades indicated no significant difference (p > 0.05); however, the 2020 cohort demonstrated superior class performance (p < 0.01) and practical performance (p < 0.05).

The CBL + TBL model, combined with the SOAP framework, markedly improves students’ clinical reasoning, practical abilities, and learning engagement in the PTOD course, providing a more effective alternative to traditional teaching methods for rehabilitation education reform.