Career-long learning: Relationship between cognitive and metacognitive skills

Abstract

Objectives: Physicians need metacognitive skills including reflection and goal generation for effective lifelong learning (LLL). These skills are not readily assessed and may not correlate with cognitive skills. We examined early-career physicians’ metacognition and relationships between metacognitive skills, cognitive skills, and orientation toward LLL.

Methods: Pediatric fellows at UCSF document career progress in annual Individual Development Plans (IDPs). To assess metacognitive skills, we scored narratives in IDPs with a Reflective Ability Rubric (RAR) and goal setting with a SMART Goal Rubric (SMART-GR: consists of global IDP score and four IDP domain subscores). To assess cognitive skills, we collected American Board of Pediatrics scores (ABP), and to measure orientation toward LLL, fellows completed the Jefferson Scale (JeffSPLL). We used Spearman’s correlation to examine relationships between scores.

Results: About 57/66 (86%) fellows participated. Mean scores were: RAR 2.4 ± 1.3 (scale 0–6); SMART-GR global IDP 2.8 ± 1.0, (1–5); JeffSPLL 46.3 ± 3.9 (14–56); and ABP 559.4 ± 75.7. RAR scores correlated significantly with SMART-GR scores but metacognitive measures did not correlate with ABP scores.

Conclusions: Our study suggests early-career physicians may have limited metacognitive skills; cognitive and metacognitive skills do not correlate; and orientation toward LLL does not predict metacognitive skills. Thus, we need improved methods to teach and assess metacognition.

Acknowledgements

The authors wish to thank Sara Hoover, Nannette Nemenzo, and Twinkle Patel for their assistance with data collection, Patricia O’Sullivan and the UCSF Office of Medical Education for their thoughtful review of the study proposal and manuscript draft, and all of the pediatric subspecialty fellows who participated in the study.

Declaration of interest: I am a military service member (or employee of the U.S. Government). This work was prepared as part of my official duties. Title 17, USC, §105 provides that “Copyright protection under this title is not available for any work of the U.S. Government”. Title 17, USC, §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. The authors have no conflicts of interest to disclose. The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.