Designing and implementing a metacognitive model in healthcare simulation

Simulation-based education (SBE) is an evidence-based and widely used pedagogical approach for acquiring a range of clinical skills. However, because much of SBE takes place within isolated and controlled environments, there are limitations regarding its transfer to real-world clinical practice. While considerations such as fidelity and multidisciplinary involvement can enhance the transferability of learning outcomes to clinical settings, the cognitive and emotional demands of clinical practice, which are known to influence performance, are often overlooked. To optimise transferability from simulation to bedside care, learners need to develop their metacognitive ability to monitor and regulate their cognitive and emotional processes to the demands of practice. In this article, we highlight the importance of metacognition and share insights from the development of a conceptual metacognitive model and its implementation within SBE.