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Metacognitive awareness and confidence as predictors of academic performance in pharmacy students: insights from grade predictions and structural equation modeling

Front Psychol. 2026 Feb 27;17:1720303. doi: 10.3389/fpsyg.2026.1720303. eCollection 2026.

ABSTRACT

BACKGROUND: Pharmacy students often struggle with accurate self-assessment of learning outcomes. Many students overestimate exam performance, reflecting poor metacognitive awareness and overconfidence. This study examined the relationships between metacognitive awareness, self-confidence in grade predictions, and academic performance in pharmacy education, thus addressing how these factors interact without inferring causation.

METHODS: Pharmacy students (n = 151) at King Saud University participated in this study while enrolled in a Pathophysiology, Drug Action, and Therapeutics course. Surveys were pre-tested and post-tested twice at two midterm examinations to determine their self-reported metacognitive awareness and confidence. Students made predictions for future course grades. These self-tests were then contrasted to actual exam scores. Statistical analysis was performed using R software version 4.3.1, and students were categorized by metacognitive and confidence ability.

RESULTS: Despite underperforming on the first exam, students’ confidence in their grade predictions remained high. Students with better metacognitive awareness and well-calibrated confidence scored significantly higher on exams (p < 0.01). Metacognitive cognition and confidence were positively associated with academic performance (r = 0.467 and 0.361, p < 0.01), and with each other (r = 0.251, p < 0.01). Gender differences showed higher overall confidence and metacognitive cognition scores in males.

DISCUSSION: The results indicate that metacognition and confidence are critical for academic performance. These findings suggest that educational programs targeting self-evaluation warrant further investigation.

PMID:41835871 | PMC:PMC12982428 | DOI:10.3389/fpsyg.2026.1720303

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