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Despite decades of research on self-regulated learning (SRL), little work has been done to explore learners’ SRL sequential profiles and their connection to cognitive capacities and learning performance. Our study employs the first-order Markov model to identify different SRL sequence profiles as medical students diagnosed virtual patients in a computer-simulated learning environment. Two clusters emerged. Cluster 1 was characterized by complex cyclical SRL patterns, with frequent help-seeking and monitoring. In contrast, cluster 2 exhibited a strong linear monitor-to-evaluation process. Additionally, Cluster 1 reported higher metacognitive self-regulation and effort regulation, but lower learning outcomes than Cluster 2. Our results suggest that metacognitive complexity could overwhelm cognitive resources, demonstrating a crucial role of metacognitive regulatory efficiency in academic
success.