O conceito de metacognição aplicada à formação do enfermeiro: uma revisão de escopo
DOI:
https://doi.org/10.17267/2594-7907ijeh.2025.e6298Palavras-chave:
Metacognição, Enfermagem, Estudantes de Enfermagem, Educação em EnfermagemResumo
RESUMO | INTRODUÇÃO: A metacognição, entendida como a consciência dos seus próprios processos cognitivos, é uma habilidade importante para o aprendizado, contribuindo para o desempenho acadêmico, além de se relacionar ao desenvolvimento de raciocínio clínico. No entanto, não há revisões de escopo sobre o tema na educação em enfermagem. OBJETIVO: Assim, buscou-se mapear a aplicação do conceito de metacognição na formação de enfermeiros. MÉTODO: Realizou-se uma revisão de escopo seguindo as recomendações do Instituto Joana Briggs. Dos 142 artigos identificados nas bases de dados PubMed, Eric, SciELO e BVS, foram incluídos 21 após se aplicar critérios de elegibilidade. RESULTADOS: Encontrou-se que a metacognição possui uma vasta aplicação para a formação do enfermeiro, incluindo a relação entre: o nível de metacognição e o aprendizado; métodos de ensino; e desenvolvimento de habilidades. Embora os estudantes de enfermagem não atinjam os níveis mais elevados de metacognição, a aplicação de intervenções educacionais parece ter o potencial de aumentá-la, o que contribui para a otimização do desempenho acadêmico e no desenvolvimento de competências essenciais para o campo da enfermagem. CONCLUSÃO: Nesse sentido, a metacognição demonstra ser de grande importância para o desenvolvimento do raciocínio clínico do enfermeiro, de habilidades para a prática clínica e para a redução de erros. Portanto, a aplicação da metacognição deve ser explorada na universidade e em estudos longitudinais que ratifiquem seus efeitos na formação do enfermeiro.
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Referências
1. Flavell JH. Metacognition and cognitive monitoring: A new area of cognitive–developmental inquiry. Am Psychol. 1979;34:906–11. https://doi.org/10.1037/0003-066X.34.10.906
2. Fleur DS, Bredeweg B, van den Bos W. Metacognition: ideas and insights from neuro- and educational sciences. NPJ Sci Learn [Internet]. 2021;6(1):1–11. Available from: https://www.nature.com/articles/s41539-021-00089-5
3. Asadzandi S, Mojtahedzadeh R, Mohammadi A. What are the Factors that Enhance Metacognitive Skills in Nursing Students? A Systematic Review. Iran J Nurs Midwifery Res. 2022;27(6):475–84. https://doi.org/10.4103/ijnmr.ijnmr_247_21
4. Nes AAG, Riegel F, Martini JG, Zlamal J, Bresolin P, Mohallem AGC, et al. Brazilian undergraduate nursing students’ critical thinking need to be increased: a cross-sectional study. Rev Bras Enferm. 2023;76:e20220315. https://doi.org/10.1590/0034-7167-2022-0315
5. Facione PA. Critical Thinking: What It Is and Why It Counts. Insight Assessment [Internet]. 2015. Available from: https://www.researchgate.net/publication/251303244_Critical_Thinking_What_It_Is_and_Why_It_Counts
6. Stark M, Fins JJ. The Ethical Imperative to Think about Thinking: Diagnostics, Metacognition, and Medical Professionalism. Camb Q Healthc Ethics. 2014;23(4):386–96. https://doi.org/10.1017/S0963180114000061
7. Corrao S, Argano C. Rethinking clinical decision-making to improve clinical reasoning. Front Med. 2022;9. https://doi.org/10.3389/fmed.2022.900543
8. Banning M. Clinical reasoning and its application to nursing: Concepts and research studies. Nurse Educ Pract. 2008;8(3):177–83. https://doi.org/10.1016/j.nepr.2007.06.004
9. NANDA International, Inc. Glossary of Terms [Internet]. Available from: https://nanda.org/publications-resources/resources/glossary-of-terms/
10. Woolley N. Nursing diagnosis: exploring the factors which may influence the reasoning process. J Adv Nurs. 1990;15(1):110–7. https://doi.org/10.1111/j.1365-2648.1990.tb01679.x
11. Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, et al. Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs. 2021;77(4):2102–13. https://doi.org/10.1111/jan.14743
12. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. Adelaide: JBI; 2024. Available from: https://synthesismanual.jbi.global
13. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. https://doi.org/10.1080/1364557032000119616
14. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119–26. https://doi.org/10.11124/JBIES-20-00167
15. Jou GI, Sperb TM. Metacognition as regulatory strategy of learning. Psicol Reflex Crit. 2006;19:177–85. https://doi.org/10.1590/S0102-79722006000200003
16. Versteeg M, Bressers G, Wijnen-Meijer M, Ommering BW, Beaufort AJ, Steendijk P. What Were You Thinking? Medical Students’ Metacognition and Perceptions of Self-Regulated Learning. Teach Learn Med. 2021;33(5):473–82. https://doi.org/10.1080/10401334.2021.1889559
17. Silva MG, Fernandes JD, Teixeira GAS, Silva RM. Contemporary formal nursing education process: challenges and perspectives. Texto Contexto Enferm. 2010;19:176–84. https://doi.org/10.1590/S0104-07072010000100021
18. Hsu LI, Hsieh SI. Factors affecting metacognition of undergraduate nursing students in a blended learning environment. Int J Nurs Pract. 2014;20(3):233–41. https://doi.org/10.1111/ijn.12131
19. Chen JH, Björkman A, Zou JH, Engström M. Self-regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: A cross-sectional and correlational study. Nurse Educ Pract. 2019;37:15–21. https://doi.org/10.1016/j.nepr.2019.04.014
20. Chen SL, Sun JL, Jao JY. A predictive model of student nursing competency in clinical practicum: A structural equation modelling approach. Nurse Educ Today. 2020;95:104579. https://doi.org/10.1016/j.nedt.2020.104579
21. Jin M, Ji C. The correlation of metacognitive ability, self-directed learning ability and critical thinking in nursing students: A cross-sectional study. Nurs Open. 2021;8(2):936–45. https://doi.org/10.1002/nop2.702
22. Espindola CKN, Santos DBD, Nascimento LL, Matos RS, Silva SMD, Marion-Martins AD. Perfil metacognitivo de estudantes de enfermagem e desempenho acadêmico. Rev Enferm UFPE On Line [Internet]. 2021;15(2):1–16. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/244980/39181
23. Bektas I, Bektas M, Ayar D, Akdeniz Kudubes A, Sal S, Selekoglu OK, et al. The predict of metacognitive awareness of nursing students on self-confidence and anxiety in clinical decision-making. Perspect Psychiatr Care. 2021;57(2):747–52. https://doi.org/10.1111/ppc.12609
24. Choi E, Jeon J. Factors Influencing Problem-Solving Competence of Nursing Students: A Cross-Sectional Study. Healthcare (Basel). 2022;10(7). https://doi.org/10.3390/healthcare10071184
25. Kim S. The effect of metacognition and self-directed learning readiness on learning performance of nursing students in online practice classes during the COVID-19 pandemic period. Nurs Open. 2024;11(1):e2093. https://doi.org/10.1002/nop2.2093
26. Seidel-Fischer J, Trifunovic-Koenig M, Gerber B, Otto B, Bentele M, Fischer MR, et al. Interaction between overconfidence effects and training formats in nurses’ education in hand hygiene. BMC Nurs. 2024;23(1):451. https://doi.org/10.1186/s12912-024-02020-w
27. Lee S, Park H, Yu S. The mediating role of positive psychological capital in the relationship between metacognition and self-directed learning ability: A cross-sectional study. Nurse Educ Today. 2024;143:106385. https://doi.org/10.1016/j.nedt.2024.106385
28. Wang J, Jiao Y, Peng M, Wang Y, Guo D, Tian L. The relationship between personality traits, metacognition and professional commitment in Chinese nursing students: a cross-sectional study. BMC Nurs. 2024;23(1):729. https://doi.org/10.1186/s12912-024-02399-6
29. Gholami M, Moghadam PK, Mohammadipoor F, Tarahi MJ, Sak M, Toulabi T, et al. Comparing the effects of problem-based learning and the traditional lecture method on critical thinking skills and metacognitive awareness in nursing students in a critical care nursing course. Nurse Educ Today. 2016;45:16–21. https://doi.org/10.1016/j.nedt.2016.06.007
30. Lee MN, Nam KD, Kim HY. Effects of Simulation With Problem-Based Learning Program on Metacognition, Team Efficacy, and Learning Attitude in Nursing Students: Nursing Care With Increased Intracranial Pressure Patient. Comput Inform Nurs. 2017;35(3):145–51. https://doi.org/10.1097/cin.0000000000000308
31. Oh HK. Impact of Metacognition on Clinical Judgment and Competence in Simulation-Based Blended Learning. Int J Mob Blended Learn [Internet]. 2019;11(3):79–88. Available from: https://ideas.repec.org/a/igg/jmbl00/v11y2019i3p79-88.html
32. Donaldson S. Building Metacognition and Thinking Using a Deliberate Approach. Collect Essays Learn Teach. 2020;13:12–24. https://doi.org/10.22329/celt.v13i0.6009
33. Millanzi WC, Kibusi SM. Exploring the effect of problem-based facilitatory teaching approach on metacognition in nursing education: A quasi-experimental study of nurse students in Tanzania. Nurs Open. 2020;7(5):1431–45. https://doi.org/10.1002/nop2.514
34. Lovell C, Elswick RK Jr, McKay SW, Robins J, Salyer J. Visual Arts in Nursing Education: An Inventive Interprofessional Initiative to Cultivate Metacognitive Awareness in Beginning Nursing Students. J Holist Nurs. 2021;39(2):135–43. https://doi.org/10.1177/0898010120962903
35. Rashwan ZI, Busebaia TJ, Al-Sabbagh AS, Eweida RS. Effect of guided reciprocal peer questioning strategy on pediatric nursing students’ self-esteem and metacognitive awareness: Current approach and future directions. Nurse Educ Today. 2021;107:105153. https://doi.org/10.1016/j.nedt.2021.105153
36. Li S, Ala M, Mao D, Wang A, Wu C. Effect of a Nursing Comprehensive Skill Training Course (NCST-C) on Nursing Students’ Metacognitive Awareness: A Quasi-experimental Study. Asian Nurs Res. 2022;16(5):275–81. https://doi.org/10.1016/j.anr.2022.10.003
37. Al-Moteri M. Metacognition and learning transfer under uncertainty. Int J Nurs Educ Scholarsh. 2023;20(1). https://doi.org/10.1515/ijnes-2023-0038
38. Schraw G, Dennison RS. Assessing Metacognitive Awareness. Contemp Educ Psychol. 1994;19(4):460–75. https://doi.org/10.1017/S0963180114000061
39. Siqueira MAM, Gonçalves JP, Mendonça VS, Kobayasi R, Arantes-Costa FM, Tempski PZ, et al. Relationship between metacognitive awareness and motivation to learn in medical students. BMC Med Educ. 2020;20(1):393. https://doi.org/10.1186/s12909-020-02318-8
40. Salari M, Hamzah R, Hambali Z. Meta-Cognitive Strategies and Nursing Students’ Achievement. J Educ Vocat Res [Internet]. 2013;4(6):169–73. Available from: https://ideas.repec.org/a/rnd/arjevr/v4y2013i6p169-173.html
41. Shin IS, Kim JH. The effect of problem-based learning in nursing education: a meta-analysis. Adv in Health Sci Educ. 2013;18:1103-20. https://doi.org/10.1007/s10459-012-9436-2
42. Jeppesen KH, Christiansen S, Frederiksen K. Education of student nurses – A systematic literature review. Nurse Educ Today. 2017;55:112–21. https://doi.org/10.1016/j.nedt.2017.05.005
43. Medina MS, Castleberry AN, Persky AM. Strategies for Improving Learner Metacognition in Health Professional Education. Am J Pharm Educ. 2017;81(4):78. https://doi.org/10.5688/ajpe81478
44. Immonen K, Oikarainen A, Tomietto M, Kääriäinen M, Tuomikoski AM, Kaucic BM, et al. Assessment of nursing students’ competence in clinical practice: A systematic review of reviews. Int J Nurs Stud. 2019;100:103414. https://doi.org/10.1016/j.ijnurstu.2019.103414
45. Sáiz-Manzanares MC, Escolar-Llamazares MC, González ÁA. Effectiveness of Blended Learning in Nurding Education. Int J Environ Res Public Health. 2020;17(5):1589. https://doi.org/10.3390/ijerph17051589
46. Croskerry P. The importance of cognitive errors in diagnosis and strategies to minimize them. Acad Med. 2003;78(8):775–80. https://doi.org/10.1097/00001888-200308000-00003
47. Graber M. Metacognitive Training to Reduce Diagnostic Errors: Ready for Prime Time? Acad Med [Internet]. 2003;78(8):781. Available from: https://journals.lww.com/academicmedicine/fulltext/2003/08000/metacognitive_training_to_reduce_diagnostic.4.aspx
48. Royce CS, Hayes MM, Schwartzstein RM. Teaching Critical Thinking: A Case for Instruction in Cognitive Biases to Reduce Diagnostic Errors and Improve Patient Safety. Acad Med. 2019;94(2):187–94. https://doi.org/10.1097/ACM.0000000000002518
49. Iskander M. Burnout, Cognitive Overload, and Metacognition in Medicine. Med Sci Educ. 2019;29(1):325–8. https://doi.org/10.1007/s40670-018-00654-5
50. Kayalar A, Hiçdurmaz D. Effects of metacognitions, self-compassion, and difficulties in emotion regulation on psychological resilience in oncology nurses. Eur J Oncol Nurs. 2024;70:102568. https://doi.org/10.1016/j.ejon.2024.102568
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Copyright (c) 2025 Keully Tiffany Mota Guerreiro, Cristiane Aschidamini
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Esta obra está licenciada com uma Licença Creative Commons Atribuição 4.0 Internacional.
