PhenomenonAs a component of self-regulated learning, metacognition is gaining attention in the medical education research community. Metacognition, simply put, is thinking about one's thinking.... Show morePhenomenonAs a component of self-regulated learning, metacognition is gaining attention in the medical education research community. Metacognition, simply put, is thinking about one's thinking. Having a metacognitive habit of mind is essential for healthcare professionals. This study identified the metacognitive competencies of medical students as they completed a conceptual learning task, and provided insight into students' perceptions of self-regulated learning in their curriculum. Approach: Eleven third-year medical students from a Dutch University were purposively sampled to participate in this qualitative study. The study design included a think-aloud assignment followed by a semi-structured interview. During the assignment, participants were instructed to think aloud while solving questions about medical physiological concepts such as blood flow, pressure, and resistance. Think-aloud data were collected through audiotaping and used to identify participants' metacognitive competencies. The assignment also served as a prompt for an interview in which participants were questioned about metacognitive knowledge, monitoring, experiences, and perceptions of self-regulated learning in their curriculum. All data were transcribed verbatim and analyzed iteratively using a template analysis. Findings: Students differed in their use of metacognitive skills, with an overall focus on monitoring and, to a lesser extent, on planning and evaluation. Additionally, differences were found in students' metacognitive knowledge and metacognitive experiences. There was apparent use of inefficient, superficial predictive cues. Regarding perceptions of self-regulated learning skills, some students felt no need to develop such skills as they perceived medical education as an exercise in memorizing facts. Others emphasized the need for more insight into their actual level of knowledge and competence. Insights: Pre-clinical medical students require explicit teaching of metacognitive skills to facilitate self-regulated learning. Educators should aim to integrate metacognition in the everyday discourse of the classroom to foster an environment in which students discuss their own learning.Supplemental data for this article is available online at . Show less
Students learn more effectively when they know what they do not know. Gaining insight into students' metacognitive awareness is needed as misalignment between actual and self-perceived knowledge... Show moreStudents learn more effectively when they know what they do not know. Gaining insight into students' metacognitive awareness is needed as misalignment between actual and self-perceived knowledge impedes their learning process. The optimal method of measuring self-perceived knowledge is still under debate. In this study, we evaluate the use of psychology-derived post-decision wagering for mapping students self-perceived knowledge.Students (n = 71) performed a pre-test on medical physiology, followed by a teacher-moderated discussion and a post-test with isomorph questions. Half of the students rated their self-perceived knowledge on each question using post-decision wagering, i.aEuroe. betting 1-5 points on the correctness of their answer, whereas the other half used a 5-point Likert scale to rate their confidence.Self-perceived knowledge scores were higher for post-decision wagering (pre: 3.75 +/- 0.14, post: 4.60 +/- 0.07) compared with Likert scales (pre: 3.13 +/- 0.08, post: 3.92 +/- 0.08) despite similar actual knowledge scores. Furthermore, Likert ratings showed a near-normal distribution, whereas wagers were placed preferentially using the outer ends of the scale. Correlations between mean actual and self-perceived knowledge scores were low in both groups. On average, 8.5% of responses were classified as misconceptions, defined as highly confident incorrect answers.Despite the presumed reliability of post-decision wagering, our findings suggest that we should adhere to the use of Likert scales as a balanced measure for self-perceived knowledge in medical education. Moreover, the prevalence of misconceptions did not alter after instruction, indicating a need for instructional designs that enhance students' conceptual understanding in basic sciences. Show less
