Abstract
BACKGROUND: Trauma orthopaedics presents unique challenges in medical education due to complex fracture morphology and the limitations of traditional lecture-based approaches. Problem-Based Learning (PBL) emphasizes active participation and clinical reasoning, while three-dimensional visualization reconstruction technology (3D-VRT) enhances spatial understanding of anatomy and fracture patterns. However, the combined application of PBL and 3D-VRT in trauma orthopaedics education has not been fully evaluated. METHODS: A single-blinded randomized controlled trial was conducted at the First Affiliated Hospital of Wannan Medical College, enrolling 50 clinical medical students between July 2023 and June 2024. Students were randomly assigned to the control group (traditional teaching, n = 25) or the experimental group (PBL combined with 3D-VRT, n = 25). Teaching effectiveness was assessed by written examinations, practical skill evaluations, a critical thinking disposition inventory, student evaluations of teaching methods, and a teaching satisfaction questionnaire. RESULTS: Before the intervention, baseline performance showed no significant difference between the two groups. After the intervention, the experimental group demonstrated higher written examination scores (84.72 ± 2.39 vs. 79.52 ± 2.21, mean difference = 5.20, 95% CI: 3.62–6.78, P < 0.01) and practical operation scores (86.68 ± 2.22 vs. 79.24 ± 2.96, mean difference = 7.44, 95% CI: 5.82–9.06 P < 0.01) compared with the control group. Critical thinking ability scores were higher in the experimental group across all seven dimensions (total score 361.36 ± 11.46 vs. 256.96 ± 8.89, mean difference = 104.4, 95% CI: 95.1–113.7, P < 0.05). Student evaluations of teaching effectiveness (17.84 ± 1.12 vs. 10.72 ± 1.59, mean difference = 7.12, 95% CI: 5.51–8.73, P < 0.05) and overall teaching satisfaction (85.92 ± 4.34 vs. 74.96 ± 5.64, mean difference = 10.96, 95% CI: 8.24–13.68,P < 0.05) were also improved in the experimental group. CONCLUSION: The integration of PBL with 3D-VRT was associated with improved knowledge acquisition, practical skills, critical thinking ability, and teaching satisfaction among medical students in trauma orthopaedics education. This blended approach addresses the limitations of traditional teaching and offers a promising strategy for improving educational outcomes in trauma orthopaedics. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08364-4.