Six teaching methods on the effectiveness of community nursing education for nursing students in China: A systematic review and network meta-analysis

Aim: This study aims to compare the effectiveness of six different teaching methods with traditional teaching approaches in community nursing education for nursing students in China. Background: In recent years, an increasing number of Chinese nursing educators exploring various pedagogical approaches to enhance the educational outcomes in community nursing. However, there is still no consensus on the superiority of different teaching methods and no direct comparisons of their effectiveness have been made. Therefore, evaluating the impact of six teaching strategies on community nursing education for Chinese nursing students is both necessary and timely. Design: This study is a systematic review and network meta-analysis. Methods: In November 2024, a comprehensive search was conducted across nine databases to identify studies that met predefined inclusion and exclusion criteria. This process involved screening studies based on set criteria, extracting relevant data, and assessing the quality of the studies before conducting the network meta-analysis. The review protocol of this study was prospectively registered in the PROSPERO (CRD42025635443). Results: From an initial pool of 3077 articles, 33 were meticulously selected for a network meta-analysis. The findings indicate that PBL significantly outperforms other methods in improving nursing students' final examination scores and practical skills. PAD class approach emerged as the most effective method in fostering selfdirected learning capabilities among Chinese nursing students. Conclusion: The results of this study show that PBL and PAD class were identified as having the greatest potential to enhance Chinese nursing student academic achievement and self-directed learning. Nonetheless, future investigations should employ larger sample sizes and more rigorous methodologies to substantiate these findings. Tweetable abstract: With the increasing aging of the population in China, it is urgent for nursing educators to think about how to cultivate nursing students' interest in community nursing and improve the teaching quality of community nursing in order to meet the growing demand for primary health services. More and more nursing educators have realized the shortcomings of traditional teaching methods, so they try to use a variety of teaching methods to improve the teaching effect of community nursing. However, there is currently no consensus on the superiority of different teaching methods, and no studies have directly compared their effects. Therefore, evaluating the impact of various teaching strategies on community nursing education is both necessary and meaningful. Hence, we employed network meta-analysis to assess the effectiveness of six common teaching methods used in community nursing education in China, aiming to provide insights for the selection of appropriate teaching models for community nursing education. From the establishment of the database until November 2024, a comprehensive search of nine databases was conducted. According to inclusion and exclusion criteria, 33 literatures on community nursing teaching of nursing students in China were included for analysis. The results ranked PBL as the most effective strategy for improving both final examination scores and practical skills. Furthermore, presentation-assimilation-discussion class (PAD class) approach was identified as having the