With the rapid development of technology and societal change, a shift from traditional classroom instruction to more diverse educational methods in medical education is necessary. As an effective approach to providing flexibility and accessibility while maintaining the benefits of face-to-face interactions, blended learning, which integrates online and offline learning, has gained attention. This study examines the current status and best practices of the aforementioned blended learning, analyzes its application in domestic and international contexts, and derives effective instructional design strategies. A comprehensive review of previous research and empirical cases reveals a conceptual framework and core principles for designing such blended learning. Key considerations include strategic integration of online and offline activities, facilitation of self-directed learning and interaction, effective use of technology, and continuous quality improvement. Furthermore, we suggest contextually relevant strategies, such as designing curricula focused on clinical reasoning, providing iterative practice opportunities, enhancing reflection, and fostering future competencies. The case analysis establishes that blended learning is implemented in various forms across different medical schools and curricula. Common features include the linkage of online and offline learning, incorporation of learner-centered methods, and emphasis on practical competencies. However, the limited number of cases suggests that generalizations may be premature. Successful implementation requires multifaceted efforts, including gradual introduction, faculty support, flexible curricula, safety measures, and institutional support. Accumulating empirical research and evidence of their effectiveness can facilitate their wider dissemination. This study provides implications and future directions for innovative medical education using hybrid learning.