Evidence of the effectiveness of projects, programs, and/or strategies for curricular innovation in undergraduate health courses: systematic review and meta-analysis.

contextThe need for curricular innovation, especially in university education, is incorporated into the agenda of universities for undergraduate health courses, whether through the models adopted in educational institutions, referenced by their curricula, or through traditional practices that still prevail in the 21st century as a form of teaching, to the detriment of innovative practices. With high retention and dropout rates in university courses, the contemporary scenario calls for the development of strategies to reorganize curricula that meet the new demands of student training, implementing new projects, programs, and/or tools that stimulate new teaching and learning processes. Therefore, the objective of this study was to analyze the evidence of the effectiveness of projects, programs, and/or strategies for curricular innovation in undergraduate health courses through a systematic review and meta-analysis.

methodsThe systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and were carried out in two stages: (a) search and selection and (b) analysis and evaluation. Eight databases were used: Cochrane Library; Education Resource Information Center (ERIC); Embase; Latin American and Caribbean Health Sciences Literature (LILACS); PubMed-Medline; SCOPUS; Scientific Electronic Library Online (SciELO); and Web of Science. The review included qualitative research, cohort studies, cross-sectional and quasi-experimental analytical studies that addressed evidence of the effectiveness of projects, programs, and/or strategies for curricular innovation in undergraduate health courses. The quality of the selected studies was assessed based on the Joanna Briggs Institute evaluation criteria. The meta-analysis was based on data on student satisfaction prevalence, self-efficacy, and academic performance. Publication bias was investigated by visual inspection of funnel plots and Egger's test.

resultsNinety-nine studies were included in the systematic review and 23 in the meta-analysis, covering publications from 1995 to 2024 in 19 countries, with a time span of almost three decades of studies on curricular innovations and evaluations in the health field, which provided an overview of the advances in this area. The interventions were classified into seven thematic areas: clinical simulation, interprofessional training, diversity and equity, assessment and feedback, educational leadership, humanistic education, and digital teaching. The studies analyzed highlighted that curricular innovations promote the improvement of critical skills, such as critical thinking, clinical reasoning, and interprofessional teamwork, in addition to increasing student satisfaction and engagement. Advances were also observed in the development of humanistic skills, cultural sensitivity, and adaptation to digital technologies and online education. These interventions positively impacted health education, strengthening technical competencies and clinical skills, while transforming institutional culture by valuing collaborative teaching practices. Students exposed to early practical experiences reported greater motivation, confidence, and satisfaction with the course, reflecting more robust preparation for professional challenges. In addition, the results of the meta-analysis showed a weighted prevalence of 82% (76%-88%) for student satisfaction, 67% (49%-86%) for self-efficacy, and 70% (64%-75%) for academic performance after the implementation of curricular interventions. Furthermore, it was observed that most studies showed significant positive effects on outcomes after the adoption of these interventions.

conclusionThe findings suggest that curricular interventions have the potential to positively impact the training of health professionals. Thus, we conclude that curricular innovation strategies in health courses are promising, based on improvements in self-efficacy, academic performance, and student satisfaction, promoting indicators of teaching quality in the contexts in which they were carried out. We recommend the development of longitudinal and multicenter studies that investigate the effects of these innovations on professional practice and the quality of health care, considering different cultural and institutional contexts.