Metacognitive Clues to Improve Medical Student Efficiency and Performance in Physiology Education

Medical students must master an extensive amount of basic science knowledge in the first year of the curriculum. The large number of lecturers and contact hours may make it difficult for students to ascertain key concepts in the material. Physiology faculty members have created extensive notes and PowerPoints to assist student comprehension. Study guides, practice questions, and review sessions are also provided in the coursework to help students determine the highest-yield topics for success. However, these supplemental resources are typically provided or utilized after the lecture content is presented. For this study, the physiology course notes were revised to contain callout boxes with metacognitive “clues” to help students plan their study time more efficiently. It was hypothesized that these clues would be positively perceived by students and improve their grades on summative assessments. The callout boxes classified the content in the first year of the physiology curriculum into categories. These included: 1. Building Block: This background knowledge is necessary for success; 2. VIC (Very Important Concept): This is a high-yield topic for assessments; 3. Know by Heart: You need to memorize this equation or numbers for reference; 4. Apply It: You will be asked to apply this information to novel clinical scenarios; 5. Tricky, Tricky: This is a common area of student misconceptions; 6. Numbers Ninja: These values need to be memorized/You should be prepared to complete a calculation. 7. No Numbers: Please focus on the concept rather than the specific values. 8. Back Pocket: This topic is being introduced but will be expanded upon more fully in upcoming lectures. The use of the metacognitive clues significantly increased medical student scores when compared to the previous cohort of the class, with an increase of 3.42% on summative assessments (P=0.02, t-test, n=164-166). On anonymous online surveys, medical students reported that the callout boxes were utilized when studying the course material, were perceived to be helpful, did not distract them when studying, and enabled them to study more efficiently. One student described, " Medical school is about more than just studying; it’s also about what you study and how you study. When professors explicitly indicate what we should devote our time to, it makes expectations clearer and learning easier.” Of the 53 respondents for the survey, 98% indicated that they felt callout boxes should be added to additional sections of the medical curriculum. These results suggest that metacognitive clues can subjectively improve the experience of medical students in a busy curriculum and improve performance on summative assessments. Future studies will analyze the effectiveness of these strategies with more complex physiological topics in the second year of the curriculum. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.