A Qualitative Analysis of Metacognition in Simulation

Background: Metacognition enables understanding, analysis, and regulation of one's cognition when engaged in learning. Metacognition, epistemic questioning, and self-regulated learning are foundational to the development of critical reasoning and self-reflective practice. Method: This pilot qualitative study used observations and interviews to identify metacognitive strategies used by a convenience sample of nursing students prior to and during simulation and debriefing. Metacognitive taxonomies were used to code the observations and interviews. Results: Coding evaluation identified that although students participated in some types of metacognition during simulation and debriefing, they did not engage in the complete metacognitive trajectory necessary for self-regulated learning. Conclusion: Simulation design lends itself to the use of metacognitive strategies. Students would benefit from these strategies being implemented throughout prebriefing, simulation, and debriefing. Further research is needed concerning strategies to increase metacognition in simulation and debriefing and whether prior student training in metacognitive skills affects simulation and debriefing learning outcomes.