Longitudinal evaluation of pharmacy students' metacognition in interpretation of evidence-based medicine

Metacognition is one's ability to "think about thinking" and to understand what knowledge and skills one has. Pharmacy professionals are required to have high metacognitive skills to ensure they are aware of what information they know and when to utilize resources. This longitudinal evaluation of pharmacy students' metacognitive ability was conducted via analysis of students' knowledge and confidence in evidence-based medicine (EBM) skills.

A survey was administered to the graduating classes of 2017 and 2018 four times, from the beginning of the second-year drug literature evaluation course (baseline) through graduation. The surveys included seven self-confidence questions for which a corresponding knowledge question was asked. Students' metacognition was evaluated on the basis of whether the level of confidence was a "match" or a "mismatch" to their corresponding level of knowledge of each question. The proportion of matches over time was determined.

Fifty-eight students (22%) completed all four surveys. The mean proportion of matches at baseline was 40% and increased over time until graduation when the proportion of matches was 74%. The proportion of matches at baseline for all seven questions were ranged from 33% to 57%. An improvement in meta-cognition was seen in 5 out 7 questions.

This evaluation provides evidence that as students learned material and revisited concepts, their confidence, knowledge, and potentially metacognition regarding EBM concepts increased. However, as 26% of items measured were not a match at graduation, interventions need to be designed and tested to improve student metacognition.