Metacognitive regulation in physical therapists' clinical reasoning: a scoping review

Int J Med Educ. 2026 Jun 3:17:61-76. doi: 10.5116/ijme.6a0c.4c0b.

Abstract

Objectives: The objective of this scoping review was to explore: (1) the nature and purposes of metacognitive regulation in clinical reasoning activities in Physical Therapy, and (2) the breadth and diversity of methods and tools used to assess metacognitive regulation in clinical reasoning activities in Physical Therapy.

Methods: The nine steps of the JBI guideline and the Prisma-Scr checklist were used. The Pubmed, Google Scholar, PsycINFO, EBSCO, and ERIC databases were queried. Resources published after 2000, in English and French, were searched using a broad range of terms defining metacognitive regulation. Two researchers carried out the parallel and blinded selection and extraction of data concerning the nature of metacognitive regulation (timing, type, task characteristics) and its purposes, as well as assessment methods and tools.

Results: Of the 1,025 identified articles, 36 were analyzed. An integrative model was created, synthesizing the relationships between five key characteristics: the type, timing, task, focal, interaction, and purposes of metacognitive regulation. Assessment methods showed diversity, while remaining underdeveloped overall.

Conclusions: This research formalizes a conceptual framework specific to Physical Therapists metacognitive regulation during clinical reasoning. It establishes a framework and synthesizes existing tools, opening up possible avenues to clarify and develop metacognitive regulation, or engage in research in the field of education.

Keywords: clinical reasoning; metacognitive regulation; physical therapy; reflexivity; uncertainty.

Publication types

  • Scoping Review
  • Review

MeSH terms

  • Clinical Competence*
  • Clinical Reasoning*
  • Humans
  • Metacognition*
  • Physical Therapists* / psychology