Self-regulated learning and academic success in health professions students: A systematic review

Health professions education is academically rigorous and associated with high stress, remediation, and attrition. Self-regulated learning (SRL), learners' ability to plan, monitor, regulate, and reflect on learning, may represent a modifiable contributor to academic performance. This systematic review examined associations between SRL characteristics/strategies and academic outcomes in health professions students.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PROSPERO (International Prospective Register of Systematic Reviews) registration, five electronic databases were searched for studies published between 2009 and 2024. Inclusion criteria focused on health profession students, naturally occurring SRL characteristics and strategies, and quantitative academic outcomes. Methodological quality was assessed using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies.

Forty-five observational studies were included, primarily representing medical, dental, and physical therapy students (N = 15,100) across direct- and graduate-entry professional programs. Methodological quality varied across studies, indicating heterogeneity in study rigor and reporting. The most consistent positive correlations of academic achievement included self-efficacy, strategic approaches, and effective behavioral regulation (e.g. time management and sustained effort). Metacognitive monitoring and autonomous motivation also predicted higher grades. Conversely, surface learning approaches, maladaptive regulation (e.g. procrastination/avoidance), and high test anxiety were consistently associated with poorer performance and lower GPAs.

Findings align with cyclical models of SRL, suggesting that motivational, cognitive, and behavioral regulation are critical for navigating high-stakes health professions education. Because these strategies are modifiable, programs should consider explicit, longitudinal SRL instruction. Future research should prioritize longitudinal interventions to establish causal links between specific SRL strategies and student success.