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Metacognition and Self-Regulation

Written by tlc

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Design Effective Learning Experiences

First Published:
July 25, 2025

 

Metacognition—the awareness and control of one’s thinking—and self-regulation—the ability to plan, monitor, and adjust one’s learning behaviors—are essential for academic success and professional growth in the health sciences. Together, these processes enable learners to assess what they know, identify gaps, select appropriate strategies, and evaluate their effectiveness in both academic and clinical settings. In health professions education, students face complex tasks requiring reflection, adaptability, and persistence. Teaching students to think metacognitively and regulate their learning helps them become self-directed learners capable of clinical reasoning, ethical decision-making, and lifelong improvement. These skills are not innate; they can be developed through targeted instruction and structured practice.

  
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  • Enhances Clinical Reasoning and Adaptive Expertise. Teaching students to monitor and adjust their thinking supports flexible problem-solving and decision-making in clinical contexts. Learners who self-regulate effectively are more likely to engage in thoughtful diagnostic reasoning and adapt to novel patient scenarios.
  • Improves Academic Performance and Motivation. Students in health professions programs who demonstrate stronger metacognitive awareness and self-regulated learning skills achieve higher academic performance. Time management, self-monitoring, and regulation of anxiety were among the most predictive factors for success in occupational and physical therapy programs.
    • Pucillo, E. M., & Perez, G. (2023). Metacognition and Self-regulation Influence Academic Performance in Occupational and Physical Therapy Students. Journal of Occupational Therapy Education, 7 (1), 1-8. https://doi.org/10.26681/jote.2023.070104
  • Supports Reflective Practice and Lifelong Learning. Metacognition and self-regulation form the foundation of professional reflection, a core competency in health professions education. These skills enable students to evaluate their decisions, learn from experience, and continue growing throughout their careers.
    • Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: a systematic review. Advances in health sciences education: theory and practice, 14(4), 595–621. https://doi.org/10.1007/s10459-007-9090-2

  • Make Thinking Visible. Model expert thinking through “think-alouds” when solving clinical cases or interpreting data. Encourage students to verbalize their reasoning and identify where they encounter uncertainty.
  • Use Structured Reflection Prompts. Incorporate brief activities asking students to reflect on what they understood, what strategies they used, and how they might approach similar tasks differently in the future.
  • Promote Goal Setting and Planning. Guide students in setting specific academic or clinical goals and identifying the strategies and resources needed to reach them. Revisit these goals periodically to support persistence and motivation.
  • Integrate Self-Assessment and Feedback Use. Encourage students to self-evaluate their performance using rubrics or checklists. Teach them how to interpret feedback and translate it into action plans for improvement.
  • Leverage Learning Journals and E-Portfolios. Use reflective tools that allow students to document their learning processes over time. Ask them to describe how their strategies evolve and how they adapt to different learning environments.
  • Foster a Growth-Oriented Climate. Normalize productive struggle and highlight the value of revision and resilience. Reinforce that both metacognitive awareness and self-regulatory skills can be cultivated with practice and support.
  • Use Universal Design for Learning (UDL) Principles. Design activities and assessments with flexibility in mind. Offer multiple ways for students to engage with the content and reflect on their learning. This supports metacognition and self-regulation by helping students choose strategies that work best for them.

  • Teaching Metacognitive Skills. Center for Teaching Excellence, University of Waterloo.

  • Metacognition. Center for Teaching and Learning, Columbia University.

  • Medina, M. S., Castleberry, A. N., & Persky, A. M. (2017). Strategies for Improving Learner Metacognition in Health Professional Education. American journal of pharmaceutical education, 81(4), 78. https://doi.org/10.5688/ajpe81478