Correlational Analysis of Metacognitive Awareness and Academic Performance among Phase-1 Medical Students

Background: Metacognition, defined as "thinking about thinking," represents a fundamental cognitive process governing how individuals monitor and regulate their learning. While extensive research demonstrates positive correlations between metacognitive awareness and academic performance in various educational contexts, limited investigations have examined this relationship within medical education cohorts. This study investigated the correlation between metacognitive awareness and academic performance among first-year medical students in the subject of anatomy. Methods: A quantitative, cross-sectional correlational study was conducted among 138 Phase-1 MBBS students at a medical college in central Andhra. Metacognitive awareness was assessed using the validated Metacognitive Awareness Inventory (MAI-52), comprising Knowledge of Cognition (17 items) and Regulation of Cognition (35 items) domains. Academic performance was measured using internal assessment scores in anatomy. Statistical analyses included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and one-way ANOVA. Students were stratified into tertile-based groups for comparative analysis. Results: The sample demonstrated mean theory examination scores of 45.92 ± 12.67 and total MAI scores of 37.04 ± 6.06. All correlations between MAI subscales and academic performance were positive and statistically significant. Total MAI score showed the strongest correlation with academic performance (r = 0.408, p < 0.001), followed by Regulation of Cognition (r = 0.378), Conditional Knowledge (r = 0.330), and Knowledge of Cognition (r = 0.323). Multiple regression analysis revealed that approximately 17% of variance in theory marks was explained by metacognitive components, with Regulation of Cognition emerging as the sole significant predictor (β = 0.80, p = 0.005). Cross-tabulation analysis demonstrated that 57.5% of high MAI students were high achievers, while 53.1% of low MAI students were low achievers. Conclusion: This study establishes a significant positive correlation between metacognitive awareness and academic performance in first-year medical students. Regulation of cognition emerged as the strongest predictor of academic success, suggesting that students' ability to monitor and adjust their learning strategies significantly contributes to academic achievement. These findings support the integration of metacognitive skill development into medical education curricula to enhance learning outcomes and foster self-directed learning capabilities essential for lifelong medical practice. KEYWORDS: Metacognition, metacognitive awareness, medical education, academic performance, self-regulated learning, medical students, anatomy education, learning strategies.