Metacognitive changes and sources of confidence judgements in health professions classroom learning

Introduction: The purpose of this study was to examine sources of confidence during learning to better understand metacognition and if a metacognitive intervention improves student metacognition or assessment performance. Methods: One-hundred fifty-eight doctor of pharmacy students participated in a semester-long intervention that included ratings of confidence as well as sources of their confidence judgments. Throughout the semester, students made metacognitive judgements on selected topics within the course. Students also completed a pre- and post-assessment which was used to examine changes in performance and metacognitive accuracy over time. Results: Most students appeared to anchor their confidence (i.e. judgments of learning) on prior knowledge, particularly at the beginning of the course. Students\u27 performance and judgements of learning (confidence) increased over the semester, but the gains in both were dependent on topic. Making metacognitive judgements on selected topics did not appear to help or hinder assessment performance or improve metacognitive accuracy for most topics. Conclusions: Students may need assistance recognizing that their prior knowledge may not be adequate to judge their current learning. To improve their judgements of learning, students should utilize more external sources (e.g., the textbook) rather than internal cognitive resources. Instructional strategies should model the task and coach students to competency (i.e. scaffold)