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This study examined anonymous and public feedbacks systems impact on metacognition with graduate health science candidates in two cohorts over two consecutive years (n=100). This mixed methods study compared a public response system (flashcards) with an anonymous response system (clickers) to examine learner perception, metacognitive influence, and performance outcomes. Two surveys of metacognition, the Motivated Strategies for Learning Questionnaire, performance outcomes, and interviews were used to examine the learning experience. Results indicate that the anonymous polling system impacted metacognition more productively resulting in higher performance outcomes as compared the public feedback system. Furthermore, the results indicated that there are barriers reduced to individual learning with the anonymous feedback system indicating the public feedback system may inhibit access to learning.