Abstract
BACKGROUND: Traditional educational methods often fail to adequately impart practical skills or foster initiative, highlighting the need for innovative teaching approaches. Ebbinghaus’ memory curve demonstrates a pattern of rapid forgetting, suggesting that incorporating this principle into education may improve outcomes. However, research on its application in medical training remains limited. METHOD: This prospective study enrolled 43 fifth-year students from the eight-year medical program at Sun Yat-sen University’s School of Medicine. Following randomization, students were allocated to either a traditional Case-Based Learning (CBL) group or a CBL combined with Metronomic Online Classroom (CBL + MOC) group. Both groups completed courses on thoracic trauma and closed chest drainage. Baseline assessments were conducted to confirm group comparability. After the intervention, students’ exam performance and self-confidence were measured, and subjective course satisfaction was evaluated. RESULTS: Compared with the CBL group, students in the CBL + MOC group achieved significantly higher exam scores (102.50 ± 19.66 vs. 86.58 ± 24.95, p = 0.04), particularly in mastery of fundamental knowledge (39.38 ± 7.04 vs. 33.16 ± 8.37, p = 0.02). The CBL + MOC model did not significantly improve self-confidence. However, missing offline CBL sessions was associated with reduced self-confidence (p = 0.01), especially in communication, collaboration, and critical thinking. Course satisfaction was unaffected by the teaching model. CONCLUSION: The CBL + MOC model enhances students’ academic outcomes more effectively than traditional CBL while maintaining course satisfaction. Nonetheless, offline CBL remains vital for sustaining self-confidence, particularly in skills central to medical practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-025-08427-6.