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Metacognitive judgements have been found to play an essential role in students’ learning. This current study proposes a hypothesized model to test the motivational predictors and academic outcomes of metacognitive judgements. A total of 107 medical students accomplished a clinical reasoning task within a technology-rich learning environment. PLS-SEM results revealed that students’ self-efficacy mediated the positive relationship between (mastery and performance) approach-oriented achievement goals and three types of metacognitive judgements, including ease-of-learning, judgment-of-learning, and confidence-judgment). In contrast, performance-avoidance goals had a direct negative effect on ease-of-learning. Additionally, ease-of-learning and confidence judgements were found to positively predict students’ task performances, while judgment-of-learning did not. These findings contribute to a more comprehensive framework of metacognitive judgments.