Development and evaluation of a case-based learning program integrated with the BOPPPS model in neurosurgical residency training: a prospective controlled educational study.

Background: Neurosurgical residency training requires teaching strategies that promote clinical reasoning and competency development beyond traditional lecture-based instruction. Although case-based learning (CBL) and the BOPPPS instructional model have each shown educational benefits, evidence regarding their integrated application in neurosurgical residency training remains limited. This study aimed to develop and evaluate a structured CBL program integrated with the BOPPPS instructional model and to assess its educational impact within the context of neurosurgical residency training. Methods: This study developed and implemented a CBL program integrated with the BOPPPS instructional model for neurosurgical residents. Participants were assigned to either a CBL-BOPPPS group or a traditional lecture-based teaching group for theoretical instruction. Following classroom teaching, both groups received identical ward-based clinical teaching involving real patients. Educational outcomes were evaluated using a multidimensional framework based on the Kirkpatrick model, including learner satisfaction, written examinations, Objective Structured Clinical Examination (OSCE) performance, self-perceived clinical competence, and teaching workload. Between-group comparisons were conducted using appropriate statistical analyses. Results: Compared to traditional teaching methods, the CBL-BOPPPS group exhibited significantly higher learner satisfaction and superior performance in higher-order knowledge application, clinical reasoning, treatment planning, and communication skills. Additionally, OSCE-based clinical performance and self-perceived clinical competence showed significant improvement. However, no significant differences were observed between the groups in foundational knowledge acquisition or imaging-based interpretation. Faculty preparation time and perceived teaching workload were greater in the CBL-BOPPPS group. Conclusion: The CBL-BOPPPS model represents a practical and educationally valuable approach to neurosurgical residency training. Its benefits appear to be domain-specific, preferentially enhancing higher-order competencies aligned with competency-based education while maintaining the role of traditional lectures for efficient foundational knowledge transmission. These findings support a blended instructional strategy in postgraduate neurosurgical education.