Study objective: The objective of this study was to explore how metaphoric role-play influences learning in medical students and to generate an evidence-based theoretical model explaining immersive educational engagement. Hypothesis: It was hypothesized that metaphoric role-play would facilitate immersive engagement by activating emotional, cognitive, and social learning mechanisms, thereby elaborating and extending the flow theory of learning. Methodology: An informed grounded theory approach was used. Medical students and faculty participated in metaphoric role-play sessions designed to teach complex physiological mechanisms through collaboratively developed metaphor-based stories. Participants later submitted narrative reflections several months after the activity. Reflections were anonymized, inductively coded, and compared with existing educational theories. Codes were clustered into subthemes and themes situated within the overarching constructs of opportunity and capacity derived from the flow state model. Additional learning theories were integrated into the analysis when supported by empirical data. Data: The dataset consisted of anonymized narrative reflections from medical students (n = 111) and faculty (n = 13), multi-stage coding memos, constant-comparative analysis matrices, and theoretical sampling documents supporting theme development. Summary of results: Analysis led to the development of a new theory titled “M.E.T.A.F.E.R.S.,” a mnemonic representing eight interacting educational constructs: metacognition, educational engagement, transformative learning, adaptive self-awareness, flow theory, emotional learning, reflection, and social learning. These constructs aligned with the umbrella categories of opportunity and capacity, elaborating how metaphoric role-play enables immersive, emotionally resonant learning experiences. Participants described heightened engagement, cognitive clarity, motivation, identity development, and improved teamwork when learning through metaphor-driven embodied scenarios. Conclusions: This theory elaborates how metaphoric role-play can optimize immersive flow experience and transformative learning by creating a match between students’ opportunity and capacity to act. Being a cost-free, psychologically safe, and easily scalable method, metaphoric role-play tool offers a promising approach to enhance conceptual understanding and engagement in the health sciences. Funding sources: This study did not receive any external funding. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.
Samina Malik (Fri,) studied this question.