Team-based Learning to Promote the Development of Metacognitive Awareness and Monitoring in Pharmacy Students

Abstract

Objective. To evaluate the metacognitive abilities of pharmacy students and determine whether introducing the concept along with team-based learning (TBL) enhances metacognition. Methods. Pharmacy students completed a Metacognitive Awareness Inventory (MAI) and a lowstakes pretest during the first class that evaluated students' knowledge about the therapeutic concepts that would be taught through TBL. The same questions were administered on the comprehensive final examination for the course. For each of the course assessments, students were asked to indicate their understanding of the topic and predict their performance. Actual performance was measured as a result of each assessment.Results. The pre-MAI composite score was 77.3%. Scores significantly improved by the end of the course to 84.6%. There were significant differences in both declarative knowledge and conditional knowledge when evaluating performance groups. Students in the middle performance group demonstrated the greatest ability to predict their performance on the final examination. Though these were not significant, students in the low group overestimated their performance, while students in the high group underestimated their performance. Baseline grade point average was the only factor predictive of the final examination score and the final course grade. Conclusion. Pedagogies such as TBL may support development of metacognitive skills in pharmacy students. However, intentional guidance provided by an instructor is required to improve pharmacy students' regulation of cognition skills.

Evaluating the Impact of Advanced Pharmacy Practice Experiences on Student Pharmacist Metacognition

“…3 Within pharmacy education, Martirosov and Moser introduced the concept of metacognition and assessed student metacognition before and after a semester-long team-based learning course for second-year student pharmacists at one institution. 15 Their study found that after the course, there was a significant improvement in metacognition, as measured by the 52-item MAI (77% vs. 84%, p<0.01). 15 Their study points to an option to enhance metacognition during the didactic curriculum, but no evaluation was done within experiential education.…”

“…15 Their study found that after the course, there was a significant improvement in metacognition, as measured by the 52-item MAI (77% vs. 84%, p<0.01). 15 Their study points to an option to enhance metacognition during the didactic curriculum, but no evaluation was done within experiential education. 15 A recent article in experiential education showed the enhanced metacognitive accuracy of student pharmacist self-assessment as compared with faculty assessment of student performance on entrustable professional activities (EPA) between introductory pharmacy practice experiences and the beginning of APPEs; however, there was no overall difference noted in accuracy enhancement throughout the APPE year.…”

“…15 Their study points to an option to enhance metacognition during the didactic curriculum, but no evaluation was done within experiential education. 15 A recent article in experiential education showed the enhanced metacognitive accuracy of student pharmacist self-assessment as compared with faculty assessment of student performance on entrustable professional activities (EPA) between introductory pharmacy practice experiences and the beginning of APPEs; however, there was no overall difference noted in accuracy enhancement throughout the APPE year. 12 The only EPA with enhanced metacognitive accuracy was for documentation in an electronic health record, possibly due to the reflective nature and/or increased experience with documentation.…”

“…13,14 Various strategies, activities, experiences, and approaches have been proposed to enhance metacognition in health professions students. [2][3][4][5]7,[8][9][10][11][12][13][14][15][16][17][18][19][20] In the didactic setting, methods include structured and specific learning objectives to guide learners, activities that allow them to monitor their understanding, and opportunities to evaluate their thinking during the learning and assessment processes. 2,3,7,8,11,13,[15][16][17][18][19] One medical school has incorporated an entire course focused on metacognition to stress the importance of the topic and facilitate development of this vital skill through readings, reflective activities, and group dialogue.…”

“…[2][3][4][5]7,[8][9][10][11][12][13][14][15][16][17][18][19][20] In the didactic setting, methods include structured and specific learning objectives to guide learners, activities that allow them to monitor their understanding, and opportunities to evaluate their thinking during the learning and assessment processes. 2,3,7,8,11,13,[15][16][17][18][19] One medical school has incorporated an entire course focused on metacognition to stress the importance of the topic and facilitate development of this vital skill through readings, reflective activities, and group dialogue. 9 Other proven methods to enhance metacognition in classroom-based environments include exam reviews and utilization of guided reflections.…”