{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:48:42Z","timestamp":1782888522528,"version":"3.54.5"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Group metacognition, the capacity to reflect on a group\u2019s cognitive processes, including awareness of other members\u2019 information organization, planning, and efforts for improvement, plays a critical role in collaborative learning efficacy. In medical education, group metacognition supports students in discussing clinical cases, recognizing peers\u2019 diagnostic reasoning, and jointly evaluating their team\u2019s approach to patients care. However, factors influencing group metacognitive competency remain underexplored among medical students. We hypothesized that in collaborative learning, team dynamics, team acquaintance, and instructor support may influence group metacognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2021, we recruited medical students from National Taiwan University College of Medicine who participated in a collaborative learning curriculum. We measured the influence of team acquaintance, team dynamics, and instructor support on group metacognition using the Team Collaboration Survey (TCS) and the Group Metacognitive Scale (GMS). Data were analyzed using partial least squares-structural equation modeling (PLS-SEM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 454 medical students (2nd year, 33.0%; 3rd year, 31.5%; 4th year, 35.5%) were recruited, and 432 (95.2%) completed the survey. PLS-SEM validated three TCS dimensions (team acquaintance, team dynamics, and instructor support) and four GMS dimensions (knowledge of cognition, planning, evaluating, and monitoring). Path analyses revealed significant correlations between both team acquaintance and team dynamics with all four group metacognitive dimensions. However, instructor support showed no significant correlation with metacognitive knowledge and skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Strong team dynamics and acquaintance may enhance both metacognitive knowledge and regulation in medical students. Instructors should focus on cultivating interactive group environments that promote effective collaboration. Strategies to strengthen team familiarity and interaction may enhance group metacognition in medical education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12909-025-07522-y","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T06:35:45Z","timestamp":1751351745000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of team dynamics and team acquaintance in group metacognition during medical students\u2019 collaborative learning"],"prefix":"10.1186","volume":"25","author":[{"given":"Chia-Ter","family":"Chao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Lin","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao-Ling","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mong-Wei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wei","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao-Chi","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiun","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huey-Ling","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"issue":"10","key":"7522_CR1","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1037\/0003-066X.34.10.906","volume":"34","author":"JH Flavell","year":"1979","unstructured":"Flavell JH. Metacognition and cognitive monitoring: A new area of cognitive\u2013developmental inquiry. Am Psychol. 1979;34(10):906\u201311.","journal-title":"Am Psychol"},{"issue":"4","key":"7522_CR2","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1207\/s15430421tip4304_4","volume":"43","author":"D Kuhn","year":"2004","unstructured":"Kuhn D, Dean J. David: metacognition: A Bridge between cognitive psychology and educational practice. Theory into Pract. 2004;43(4):268\u201373.","journal-title":"Theory into Pract"},{"issue":"6","key":"7522_CR3","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1007\/s11423-018-9583-0","volume":"66","author":"M Biasutti","year":"2018","unstructured":"Biasutti M, Frate S. Group metacognition in online collaborative learning: validity and reliability of the group metacognition scale (GMS). Education Tech Research Dev. 2018;66(6):1321\u201338.","journal-title":"Education Tech Research Dev"},{"key":"7522_CR4","doi-asserted-by":"publisher","first-page":"101804","DOI":"10.1016\/j.lmot.2022.101804","volume":"78","author":"N Atman Uslu","year":"2022","unstructured":"Atman Uslu N, Yildiz Durak H. Predicting learner autonomy in collaborative learning: the role of group metacognition and motivational regulation strategies. Learn Motiv. 2022;78:101804.","journal-title":"Learn Motiv"},{"issue":"3","key":"7522_CR5","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1080\/10508400802224830","volume":"17","author":"MM Chiu","year":"2008","unstructured":"Chiu MM. Flowing toward correct contributions during group problem solving: A statistical discourse analysis. J Learn Sci. 2008;17(3):415\u201363.","journal-title":"J Learn Sci"},{"issue":"1","key":"7522_CR6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3109\/0142159X.2011.558143","volume":"34","author":"MF Cutting","year":"2012","unstructured":"Cutting MF, Saks NS. Twelve tips for utilizing principles of learning to support medical education. Med Teach. 2012;34(1):20\u20134.","journal-title":"Med Teach"},{"key":"7522_CR7","doi-asserted-by":"publisher","unstructured":"Chao C-T, Hung K-Y. Emphasizing probabilistic reasoning education: Helping nephrology trainees to cope with uncertainty in the era of AI-assisted clinical practice. Nephrology 2024;29(3):169\u2013171. https:\/\/doi.org\/10.1111\/nep.14263","DOI":"10.1111\/nep.14263"},{"issue":"1","key":"7522_CR8","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1186\/s12909-020-02318-8","volume":"20","author":"MAM Siqueira","year":"2020","unstructured":"Siqueira MAM, Gon\u00e7alves JP, Mendon\u00e7a VS, Kobayasi R, Arantes-Costa FM, Tempski PZ. Martins mda: relationship between metacognitive awareness and motivation to learn in medical students. BMC Med Educ. 2020;20(1):393.","journal-title":"BMC Med Educ"},{"key":"7522_CR9","doi-asserted-by":"publisher","unstructured":"Ng IKS, Mok SF, Teo D. Competency in medical training: current concepts, assessment modalities, and practical challenges. Postgrad Med J 2024:qgae023. https:\/\/doi.org\/10.1093\/postmj\/qgae023","DOI":"10.1093\/postmj\/qgae023"},{"issue":"2","key":"7522_CR10","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s11412-020-09321-7","volume":"15","author":"D Kuhn","year":"2020","unstructured":"Kuhn D, Capon N, Lai H. Talking about group (but not individual) process aids group performance. Int J Computer-Supported Collaborative Learn. 2020;15(2):179\u201392.","journal-title":"Int J Computer-Supported Collaborative Learn"},{"issue":"5","key":"7522_CR11","doi-asserted-by":"publisher","first-page":"1714","DOI":"10.1111\/jcal.12828","volume":"39","author":"C-Y Liu","year":"2023","unstructured":"Liu C-Y, Li W, Huang J-Y, Lei L-Y, Zhang P-R. Collaborative programming based on social shared regulation: an approach to improving students\u2019 programming achievements and group metacognition. J Comput Assist Learn. 2023;39(5):1714\u201331.","journal-title":"J Comput Assist Learn"},{"issue":"1","key":"7522_CR12","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1186\/s12909-024-06116-4","volume":"24","author":"CT Chao","year":"2024","unstructured":"Chao CT, Chiu YL, Tsai CL, Lin MW, Yang CW, Ho CC, Hsu C, Chen HL. Identifying group metacognition associated with medical students\u2019 teamwork satisfaction in an online small group tutorial context. BMC Med Educ. 2024;24(1):1114.","journal-title":"BMC Med Educ"},{"key":"7522_CR13","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1016\/j.sbspro.2011.12.091","volume":"31","author":"M Laal","year":"2012","unstructured":"Laal M, Ghodsi SM. Benefits of collaborative learning. Procedia - Social Behav Sci. 2012;31:486\u201390.","journal-title":"Procedia - Social Behav Sci"},{"key":"7522_CR14","doi-asserted-by":"crossref","unstructured":"Johnson DW, Johnson RT. Social interdependence theory and cooperative learning: The teacher\u2019s role. The teacher\u2019s role in implementing cooperative learning in the classroom. edn.: Springer; 2008;9\u201337.","DOI":"10.1007\/978-0-387-70892-8_1"},{"issue":"1","key":"7522_CR15","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1080\/00313831.2015.1066440","volume":"61","author":"P N\u00e4ykki","year":"2017","unstructured":"N\u00e4ykki P, J\u00e4rvenoja H, J\u00e4rvel\u00e4 S, Kirschner P. Monitoring makes a difference: quality and Temporal variation in teacher education students\u2019 collaborative learning. Scandinavian J Educational Res. 2017;61(1):31\u201346.","journal-title":"Scandinavian J Educational Res"},{"key":"7522_CR16","unstructured":"Winne P, Hadwin A, AC Graesser. Studying as self-regulated learning. In, DJ Hacker, J. Dunlosky, &. Metacognition in educational theory and practice 1998:277\u2013304."},{"issue":"9","key":"7522_CR17","doi-asserted-by":"publisher","first-page":"512","DOI":"10.3390\/educsci11090512","volume":"11","author":"L Hogenkamp","year":"2021","unstructured":"Hogenkamp L, Van Dijk AM, Eysink THS. Analyzing socially shared regulation of learning during cooperative learning and the role of equal contribution: A grounded theory approach. Educ Sci. 2021;11(9):512.","journal-title":"Educ Sci"},{"issue":"1","key":"7522_CR18","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s11409-011-9077-5","volume":"7","author":"SP Lajoie","year":"2012","unstructured":"Lajoie SP, Lu J. Supporting collaboration with technology: does shared cognition lead to co-regulation in medicine? Metacognition Learn. 2012;7(1):45\u201362.","journal-title":"Metacognition Learn"},{"issue":"1","key":"7522_CR19","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1186\/s12909-022-03893-8","volume":"22","author":"CT Chao","year":"2022","unstructured":"Chao CT, Chiu YL, Tsai CL, Lin MW, Yang CW, Ho CC, Chen YY, Hsu C, Chen HL. Moving from Tangibility toward digitalization: investigating team dynamics and facilitator support among medical students in conventional and digital small-group tutorials. BMC Med Educ. 2022;22(1):814.","journal-title":"BMC Med Educ"},{"issue":"3","key":"7522_CR20","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1080\/00220973.2016.1277337","volume":"86","author":"S Won","year":"2018","unstructured":"Won S, Wolters CA, Mueller SA. Sense of belonging and Self-Regulated learning: testing achievement goals as mediators. J Experimental Educ. 2018;86(3):402\u201318.","journal-title":"J Experimental Educ"},{"key":"7522_CR21","doi-asserted-by":"publisher","first-page":"100624","DOI":"10.1016\/j.entcom.2023.100624","volume":"49","author":"M Kadri","year":"2024","unstructured":"Kadri M, Boubakri F-E, Kaghat F-Z, Azough A, Zidani KA. IVAL: immersive virtual anatomy laboratory for enhancing medical education based on virtual reality and serious games, design, implementation, and evaluation. Entertainment Comput. 2024;49:100624.","journal-title":"Entertainment Comput"},{"key":"7522_CR22","doi-asserted-by":"publisher","first-page":"102870","DOI":"10.1016\/j.displa.2024.102870","volume":"85","author":"M Kadri","year":"2024","unstructured":"Kadri M, Boubakri F-E, Teo T, Kaghat F-Z, Azough A, Zidani KA. Virtual reality in medical education: effectiveness of immersive virtual anatomy laboratory (IVAL) compared to traditional learning approaches. Displays. 2024;85:102870.","journal-title":"Displays"},{"key":"7522_CR23","doi-asserted-by":"publisher","first-page":"16055","DOI":"10.1109\/ACCESS.2024.3523860","volume":"13","author":"M Kadri","year":"2025","unstructured":"Kadri M, Boubakri FE, Hwang GJ, Kaghat FZ, Azough A, Zidani KA. C-IVAL: A longitudinal study of knowledge retention and technology acceptance in collaborative virtual Reality-Based medical education. IEEE Access. 2025;13:16055\u201371.","journal-title":"IEEE Access"},{"issue":"3","key":"7522_CR24","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1111\/j.1467-8535.2011.01181.x","volume":"43","author":"B Abedin","year":"2012","unstructured":"Abedin B, Daneshgar F, D\u2019Ambra J. Do nontask interactions matter? The relationship between nontask sociability of computer supported collaborative learning and learning outcomes. Br J Educ Technol. 2012;43(3):385\u201397.","journal-title":"Br J Educ Technol"},{"issue":"4","key":"7522_CR25","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1080\/07370008.2011.607930","volume":"29","author":"TK Rogat","year":"2011","unstructured":"Rogat TK, Linnenbrink-Garcia L. Socially shared regulation in collaborative groups: an analysis of the interplay between quality of social regulation and group processes. Cognition Instruction. 2011;29(4):375\u2013415.","journal-title":"Cognition Instruction"},{"issue":"3","key":"7522_CR26","doi-asserted-by":"publisher","first-page":"ar58","DOI":"10.1187\/cbe.22-01-0009","volume":"21","author":"SM Halmo","year":"2022","unstructured":"Halmo SM, Bremers EK, Fuller S, Stanton JD. Oh, that makes sense: social metacognition in Small-Group problem solving. CBE\u2014Life Sci Educ. 2022;21(3):ar58.","journal-title":"CBE\u2014Life Sci Educ"},{"key":"7522_CR27","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1023\/A:1003044231033","volume":"26","author":"G Schraw","year":"1998","unstructured":"Schraw G. Promoting general metacognitive awareness. Instr Sci. 1998;26:113\u201325.","journal-title":"Instr Sci"},{"issue":"4","key":"7522_CR28","doi-asserted-by":"publisher","first-page":"78","DOI":"10.5688\/ajpe81478","volume":"81","author":"MS Medina","year":"2017","unstructured":"Medina MS, Castleberry AN, Persky AM. Strategies for improving learner metacognition in health professional education. Am J Pharm Educ. 2017;81(4):78.","journal-title":"Am J Pharm Educ"},{"issue":"4","key":"7522_CR29","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1006\/ceps.1994.1033","volume":"19","author":"G Schraw","year":"1994","unstructured":"Schraw G, Dennison RS. Assessing metacognitive awareness. Contemp Educ Psychol. 1994;19(4):460\u201375.","journal-title":"Contemp Educ Psychol"},{"issue":"1","key":"7522_CR30","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12909-020-01995-9","volume":"20","author":"AA Hayat","year":"2020","unstructured":"Hayat AA, Shateri K, Amini M, Shokrpour N. Relationships between academic self-efficacy, learning-related emotions, and metacognitive learning strategies with academic performance in medical students: a structural equation model. BMC Med Educ. 2020;20(1):76.","journal-title":"BMC Med Educ"},{"issue":"3","key":"7522_CR31","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1016\/j.chb.2012.12.019","volume":"29","author":"H-Y Ku","year":"2013","unstructured":"Ku H-Y, Tseng HW, Akarasriworn C. Collaboration factors, teamwork satisfaction, and student attitudes toward online collaborative learning. Comput Hum Behav. 2013;29(3):922\u20139.","journal-title":"Comput Hum Behav"},{"issue":"1","key":"7522_CR32","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.chb.2008.08.010","volume":"25","author":"J Janssen","year":"2009","unstructured":"Janssen J, Erkens G, Kirschner PA, Kanselaar G. Influence of group member familiarity on online collaborative learning. Comput Hum Behav. 2009;25(1):161\u201370.","journal-title":"Comput Hum Behav"},{"issue":"11","key":"7522_CR33","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1177\/194277511000501101","volume":"5","author":"BJ Greenlee","year":"2010","unstructured":"Greenlee BJ, Karanxha Z. A study of group dynamics in educational leadership cohort and non-cohort groups. J Res Leadersh Educ. 2010;5(11):357\u201382.","journal-title":"J Res Leadersh Educ"},{"issue":"4","key":"7522_CR34","doi-asserted-by":"publisher","first-page":"235","DOI":"10.4103\/0970-258X.291298","volume":"32","author":"BS Vaishnav","year":"2019","unstructured":"Vaishnav BS, Vaishnav SB, Chotaliya M, Bathwar D, Nimbalkar S. Cognitive style assessment among medical students: A step towards achieving meta-cognitive integration in medical education. Natl Med J India. 2019;32(4):235\u20138.","journal-title":"Natl Med J India"},{"issue":"1","key":"7522_CR35","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1108\/EBR-11-2018-0203","volume":"31","author":"JF Hair","year":"2019","unstructured":"Hair JF, Risher JJ, Sarstedt M, Ringle CM. When to use and how to report the results of PLS-SEM. Eur Bus Rev. 2019;31(1):2\u201324.","journal-title":"Eur Bus Rev"},{"issue":"1","key":"7522_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","volume":"6","author":"L-t Hu","year":"1999","unstructured":"Hu L-t, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1\u201355.","journal-title":"Struct Equ Model"},{"key":"7522_CR37","unstructured":"Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics. Volume 6. pearson Boston, MA; 2013."},{"issue":"3","key":"7522_CR38","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1177\/1088868309341564","volume":"13","author":"AL Alter","year":"2009","unstructured":"Alter AL, Oppenheimer DM. Uniting the tribes of fluency to form a metacognitive Nation. Personality Social Psychol Rev. 2009;13(3):219\u201335.","journal-title":"Personality Social Psychol Rev"},{"issue":"4","key":"7522_CR39","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1037\/0021-9010.88.4.741","volume":"88","author":"CKW De Dreu","year":"2003","unstructured":"De Dreu CKW, Weingart LR. Task versus relationship conflict, team performance, and team member satisfaction: A meta-analysis. J Appl Psychol. 2003;88(4):741\u20139.","journal-title":"J Appl Psychol"},{"key":"7522_CR40","doi-asserted-by":"publisher","unstructured":"Karunaratne N, Lyons K, Molcik E, Exintaris B. Teamwork baseline assessment tool: sparking teamwork dialogues in health professions training. Med Teach 2024;46(10):1275\u20131277. https:\/\/doi.org\/10.1080\/0142159X.2024.2330566","DOI":"10.1080\/0142159X.2024.2330566"},{"issue":"3","key":"7522_CR41","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1177\/0018720815578267","volume":"57","author":"E Salas","year":"2015","unstructured":"Salas E, Grossman R, Hughes AM, Coultas CW. Measuring team cohesion: observations from the science. Hum Factors. 2015;57(3):365\u201374.","journal-title":"Hum Factors"},{"key":"7522_CR42","doi-asserted-by":"publisher","unstructured":"Delice F, Rousseau M, Feitosa J. Advancing teams research: what, when, and how to measure team dynamics over time. Front Psychol 2019;10:1324. https:\/\/doi.org\/10.3389\/fpsyg.2019.01324","DOI":"10.3389\/fpsyg.2019.01324"},{"issue":"1","key":"7522_CR43","doi-asserted-by":"publisher","first-page":"215824402211472","DOI":"10.1177\/21582440221147269","volume":"13","author":"M Dinc\u0103","year":"2023","unstructured":"Dinc\u0103 M, Lu\u015ftrea A, Cra\u015fovan M, Oni\u0163iu A, Berge T. Students\u2019 perspectives on team dynamics in Project-Based virtual learning. Sage Open. 2023;13(1):21582440221147269.","journal-title":"Sage Open"},{"issue":"3","key":"7522_CR44","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1002\/ase.2218","volume":"16","author":"AS Cale","year":"2023","unstructured":"Cale AS, Hoffman LA, McNulty MA. Promoting metacognition in an allied health anatomy course. Anat Sci Educ. 2023;16(3):473\u201385.","journal-title":"Anat Sci Educ"},{"issue":"2","key":"7522_CR45","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1111\/jcal.12887","volume":"40","author":"H Yildiz Durak","year":"2024","unstructured":"Yildiz Durak H. Feedforward- or feedback\u2010based group regulation guidance in collaborative groups. J Comput Assist Learn. 2024;40(2):410\u201336.","journal-title":"J Comput Assist Learn"},{"key":"7522_CR46","first-page":"1","volume":"11","author":"S Smith","year":"2023","unstructured":"Smith S, Hill J, Berlin K, Choate J, McCendrick L. Emotions experienced by instructors delivering written feedback and dialogic feed-forward. Teach Learn Inq. 2023;11:1\u201321.","journal-title":"Teach Learn Inq"},{"issue":"7","key":"7522_CR47","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1080\/02602938.2013.870969","volume":"39","author":"A Cathcart","year":"2014","unstructured":"Cathcart A, Greer D, Neale L. Learner-focused evaluation cycles: facilitating learning using feedforward, concurrent and feedback evaluation. Assess Evaluation High Educ. 2014;39(7):790\u2013802.","journal-title":"Assess Evaluation High Educ"},{"key":"7522_CR48","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.ecns.2021.01.008","volume":"54","author":"A Svellingen","year":"2021","unstructured":"Svellingen A, R\u00f8ssland A, R\u00f8ykenes K. Students as facilitators: experiences of reciprocal peer tutoring in Simulation-Based learning. Clin Simul Nurs. 2021;54:10\u20136.","journal-title":"Clin Simul Nurs"},{"issue":"2","key":"7522_CR49","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.hpe.2016.12.001","volume":"3","author":"S Gazula","year":"2017","unstructured":"Gazula S, McKenna L, Cooper S, Paliadelis P. A systematic review of reciprocal peer tutoring within tertiary health profession educational programs. Health Professions Educ. 2017;3(2):64\u201378.","journal-title":"Health Professions Educ"},{"issue":"2","key":"7522_CR50","first-page":"285","volume":"22","author":"E Lee","year":"2021","unstructured":"Lee E, Baird TD. Roles of autonomous motivation, individualism, and instructor support in student-centered learning in South Korea and the united States. Educational Technol Int. 2021;22(2):285\u2013309.","journal-title":"Educational Technol Int"},{"key":"7522_CR51","doi-asserted-by":"crossref","unstructured":"Bernard M, Bachu E. Enhancing the metacognitive skill of novice programmers through collaborative learning. In., edn.: Springer International Publishing; 2015. pp. 277\u201398.","DOI":"10.1007\/978-3-319-11062-2_11"},{"issue":"5","key":"7522_CR52","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s11528-022-00738-5","volume":"66","author":"C Socratous","year":"2022","unstructured":"Socratous C, Ioannou A. Evaluating the impact of the curriculum structure on group metacognition during collaborative Problem-solving using educational robotics. TechTrends. 2022;66(5):771\u201383.","journal-title":"TechTrends"},{"issue":"10","key":"7522_CR53","doi-asserted-by":"publisher","first-page":"2130","DOI":"10.1016\/j.jfma.2021.11.011","volume":"121","author":"C-T Chao","year":"2022","unstructured":"Chao C-T, Tsai C-L, Lin M-W, Yang C-W, Ho C-C, Chen H-L, Hsu C, Sheu B-C. Fully digital problem-based learning for undergraduate medical students during the COVID-19 period: practical considerations. J Formos Med Assoc. 2022;121(10):2130\u20134.","journal-title":"J Formos Med Assoc"},{"issue":"5","key":"7522_CR54","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/10401334.2021.1889559","volume":"33","author":"M Versteeg","year":"2021","unstructured":"Versteeg M, Bressers G, Wijnen-Meijer M, Ommering BWC, de Beaufort AJ, Steendijk P. What were you thinking?? Medical students\u2019 metacognition and perceptions of Self-Regulated learning. Teach Learn Med. 2021;33(5):473\u201382.","journal-title":"Teach Learn Med"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07522-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-025-07522-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07522-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:46:56Z","timestamp":1781614016000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-025-07522-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7522"],"URL":"https:\/\/doi.org\/10.1186\/s12909-025-07522-y","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"5 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The institutional review board of the National Taiwan University Hospital (NO. 202108011RIND) approved the study protocol of the current study. All participants provided verbal informed consent. The board waived the requirement for written informed consent from participants and required verbal informed consent because the data collection process was anonymized and posed negligible risk to participants. Our study adhered to the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The sponsors had no role in the study design, data collection, analysis, or result interpretation of this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Sponsor\u2019s role"}}],"article-number":"946"}}