ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
The Metacognitive Enhancement Triad (MET) Model Enhances Learning Outcomes in First-Year Emergency Medicine Residents
Provisionally accepted
- Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Introduction: This study evaluated the Metacognitive Enhancement Triad (MET) model, integrating peer-assisted learning (PAL), problem-based learning (PBL), and practice-enhanced cognitive learning (PCL), for improving first-year residents' learning outcomes and National Medical Licensing Examination (NMLE) performance. Methods: A quasi-experimental study was conducted at a tertiary academic medical center. 24 first-year residents received conventional training (pre-intervention), while 22 received the MET intervention (post-intervention). The MET model comprised: (1) PAL groups formed by diagnostic assessment; (2) Constructivist PBL sessions led by mentors; (3) Clinical rotations restructured to align with NMLE content (PCL). Primary outcomes were NMLE scores and pass rates. Secondary outcomes were self-reported competencies and satisfaction measured on a 10-point Likert scale. Results: The post-intervention cohort showed significantly higher NMLE scores (429 ± 41 vs. 388 ± 46, p<0.01) and pass rates (90.9% vs. 62.5%, p<0.01). They also reported greater improvement in professionalism, integrated clinical proficiency, lifelong learning, and overall satisfaction (all p<0.05). Conclusion: The MET model significantly enhanced NMLE performance and key competencies among first-year emergency medicine residents, offering an effective framework for residency training.
Keywords: standardized residency training, metacognition, National MedicalLicensing Examination, peer-assisted learning, Problem-Based Learning
Received: 07 Oct 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Ding, Jiang, Qian and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shanxiang Xu, 2201027@zju.edu.cn
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