Assessing Student Physical Therapists

Internet Journal of Allied Health Sciences and Practice Volume 23 Number 4 Article 30 October 2025 Assessing Student Physical Therapists' Metacognition in a Foundational Course in an Accelerated Curriculum Dalila Dias Nova Southeastern University, Cheryl J. Hill Nova Southeastern University, Annie Burke-Doe PT, MPT, PhD Hawaii Pacific University, Follow this and additional works at: https://nsuworks.nova.edu/ijahsp Part of the Medicine and Health Sciences Commons Recommended Citation Dias D, Hill CJ, Burke-Doe A. Assessing Student Physical Therapists' Metacognition in a Foundational Course in an Accelerated Curriculum. The Internet Journal of Allied Health Sciences and Practice. 2025 Oct 15;23(4), Article 30. This Manuscript is brought to you for free and open access by the Dr. Pallavi Patel College of Health Care Sciences at NSUWorks. It has been accepted for inclusion in Internet Journal of Allied Health Sciences and Practice by an authorized editor of NSUWorks. For more information, please contact . Assessing Student Physical Therapists' Metacognition in a Foundational Course in an Accelerated Curriculum Abstract Introduction: This study addressed the problem of limited empirical evidence on the effective assessment and implementation of metacognitive strategies in accelerated health programs. Certainty-based markings have been implemented in health education to cultivate students’ self-monitoring and regulating skills; however, they have not been evaluated in a foundational course in an accelerated healthcare program. The theoretical framework that grounded this study was the metacognitive theory. Methods: A systematic review of the literature was performed by searching ProQuest, PubMed, EBSCO, and CINAHL databases Using a one-group pre-posttest study design, the research questions explored whether certainty-based markings improved student physical therapists’ test performance, quality of knowledge, and metacognitive self-regulation in a foundational pathophysiology course in an accelerated Doctor of Physical Therapy program. Results: Descriptive analysis of pretests, posttests, and pre-posttests indicated a statistically significant increase in mean change scores across all study modules with a variation in magnitude of effect from small/medium to large and a statistically significant increase in metacognitive self-regulation with a small effect size. Conclusions: This study indicated that certainty-based markings, a cognitive monitoring strategy, improved student physical therapists’ test performance, quality of knowledge, and metacognition. These findings provide empirical evidence regarding the importance of implementing metacognitive strategies in accelerated health programs to enhance the teaching and learning of foundational concepts using keywords. Author Bio(s) Dalila Dias PT, DPT, EdD, is an Associate Professor at Nova Southeastern University in Fort Lauderdale, FL. Dr. Dias has been in physical therapy education for 9 years. Cheryl J. Hill, PT, DPT, PhD, is a professor at Nova Southeastern University; she has been in physical therapy education with this university for 31 years. Annie Burke-Doe PT, MPT, PhD, is a Professor and Program Director at Hawaii Pacific University in Las Vegas, NV. Dr. Burke-Doe has been in physical therapy education for over 25 years. This manuscript is available in Internet Journal of Allied Health Sciences and Practice: https://nsuworks.nova.edu/ijahsp/vol23/iss4/30 Dedicated to allied health professional practice and education Vol. 23 No. 4 ISSN 1540-580X Assessing Student Physical Therapists’ Metacognition in a Foundational Course in an Accelerated Curriculum Dalila Dias, PT, DPT, EdD1 Cheryl J. Hill, PT, DPT, PhD1 Annie Burke-Doe, PT, DPT, PhD2 1. 2. Nova Southeastern University Hawaii Pacific University United States ABSTRACT Introduction: Accelerated health care curricula allow learners to obtain credentials in a shorter time frame, but there is little research on their effectiveness for student learning and self-regulation. Foundational courses in accelerated programs pose challenges due to dense content and rapid pace. Metacognitive strategies, particularly those involving self-monitoring and selfregulation, may help students improve performance and learning quality. Certainty-based markings (CBM) are one such strategy that requires students to report their confidence in each answer, potentially enhancing metacognitive accuracy. Methods: In this pilot study, we used a one-group pre-posttest design to implement CBM in four modules of a first-term pathophysiology course within an accelerated Doctor of Physical Therapy (DPT) program. We examined whether CBM (independent variable) improved student test performance, quality of knowledge (composite scores), and metacognitive self-regulation (MSR) (dependent variables). Fifty-five DPT students participated, with complete data obtained from 53 students (after excluding two with incomplete participation). Students took pre-quizzes and post-quizzes with CBM in each module and completed the MSR subscale of the Motivated Strategies for Learning Questionnaire (MSLQ) before the first and after the last module. Results: Posttest scores were significantly higher than pretest scores in all four modules (Module 6 p = 0.02; Module 7 p < 0.001; Module 8 p < 0.001; Module 9 p = 0.002), indicating improved test performance with CBM. The mean improvement (pre-post change) per module ranged from 0.32 to 1.79 (out of 5 points), with effect sizes from small/medium to large. Composite scores (reflecting quality of knowledge and confidence) also showed significant mean increases across modules (range of changes: 3.24 to 9.98 (out of 15), demonstrating improved depth of knowledge. MSR scores increased significantly from pre-course to post-course (mean change = 0.16 on a 7point scale, p = 0.04), indicating enhanced metacognitive self-regulation with a small effect size. Conclusions: This pilot study demonstrates that implementing CBM in an accelerated DPT pathophysiology course improved test performance, quality of knowledge, and metacognitive self-regulation. These findings provide empirical support for using metacognitive strategies like CBM in accelerated health programs to help students monitor their learning and bridge knowledge gaps. The study underscores the importance of incorporating structured self-monitoring tools to foster metacognition in fast-paced curricula. Keywords: metacognition, cognitive monitoring, cognitive regulation, self-regulated learning, foundational courses, pathophysiology, accelerated health care curricula, traditional health care curricula, CBM, confidence-based markings, pre-test, posttest ©The Internet Journal of Allied Health Sciences and Practice, 2025 ASSESSING STUDENT PHYSICAL THERAPISTS’ METACOGNITION 1 INTRODUCTION In recent decades, there has been a shift from traditional to accelerated health care curricular design to meet the workf (...truncated)