Have you ever been aware of yourself thinking about your own thinking and made attempts to regulate this? If so, this is what we call metacognition. This process is key to every profession and for those of us wishing to pursue lifelong learning. It is a defining feature of being human, its essence contributing to a life well-lived. I find it astonishing to think that the brain can turn its thoughts upon itself.

“there is nothing that can be perceived by me more easily or more clearly than my own mind”.

René Descartes

What is metacognition?

Metacognition refers to our ability to recognise our own cognitive processing whether this is related to knowledge, strategies or experiences. Flavell, 1979 broke this down into 3 facets as shown.

Getting to know your own mind for learning

Self-awareness has long been touted as beneficial, dating back to times before the ancient Greeks. It has long been perceived as awareness to strive for, instilling a sense of a life well-lived. Despite this, metacognition has only recently become an area subject to the spotlight of scientific inquiry.

Metacognition often hones in on 3 key self-assessment skills:

• Planning
• Monitoring
• Evaluating

Let’s take a student undertaking a project. They need to be aware of the need to plan ahead which will include deciding what they need to learn and how to learn this. Then they will need to monitor their plan constantly as they execute it to ensure they are on track to achieve their desired outcome. Finally, they will need to evaluate their work or have it evaluated at the final stage to ensure it is correct and appropriate. This process will allow the student to gain insight into their own way of working and make adjustments as required. This helps facilitate lifelong transferrable skills that will remain invaluable.

“Too often, we teach students what to think but not how to think.”

OECD Insights (2014)

Why is metacognition important?

Fundamentally, metacognition affords us the unique insight to realise what we know and what we do not know. Used correctly, this can allow us to harness a significant amount of power as we endeavour to reach our potential. This may sound simple, but it is easy to ‘pass by’ in the rush and distractions of our daily lives in the modern age. Taking time to reflect on our thinking may seem like a luxury but I would argue it is anything but. I would argue that this needs to become a deliberate and intentional action in order to maximise the benefit we derive from our sophisticated brains. If you can acknowledge where the gaps in your knowledge or skills lie, it provides the opportunity and drive to search for a means to close this gap. For doctors such as myself, it is a key skill as it allows us to hone in on what clinical knowledge or guidance we need to learn, refresh our memories and ensure we continue striving to provide the best patient-centred care possible.

However, metacognition remains difficult to study due to dual causality: the purpose of monitoring is to self-regulate, and this in turn influences monitoring. It all becomes quite complicated but this paper goes into this issue in more detail for those interested.

Meditation and metacognition

Interestingly, a study by Fox et al., demonstrated that experienced meditators were better at introspection using both subjective and objective measures. This runs contrary to what psychologists thought during much of the 20th century when it was thought that subjective measures of introspection could not be accurate. However, this study showed high mean introspective accuracy amongst the experienced meditators and the converse amongst novices. The paper makes reference to functional MRI studies undertaken on meditators demonstrating cortical thickening in areas of the brain related to introspection, which is fascinating. Ultimately, this study suggests that those with greater meditation experience may provide more accurate reports of mental experience. Although this was related to awareness of tactile experiences, it may transfer to general improvements in sustained attention and objective awareness of our bodies, thoughts and emotions. This remains speculative.

Benefits of metacognition

Some purported benefits of metacognition:

• Improved academic performance
• Promotes autonomy
• Promotes resilience
• Expand understanding of self
• Better decision making
• Improved collaboration
• Prevention of diagnostic error for medical professionals

Is metacognition always helpful?

Elisabeth Norman argues, in a paper published in 2020, that the research on metacognition rarely gives due diligence to its disadvantages. She breaks this down into 3 fundamental elements:

• Metacognition may actively interfere with task performance: concurrent explanation of metacognition can impair performance, commonly referred to as ‘verbal overshadowing’.
• Cost of enaging in metacognitive strategies may outweight the benefits: spending cognitive resources and time on metacognitive strategies may not outweigh the purported benefits. Also, introspecting during a task/project may not necessarily improve performance.
• Metacognitive judgements or feeling involving a negative self-evaluation may detract from psychological well-being: there could be an adverse effect on beliefs of self-worth and abilities, whether correct or incorrect, and the added stress related to this could reduce overall well-being.

Summary

Metacognition can be helpful in many ways, and meditation practice may contribute to the ability to engage in this practice. Often, we engage in metacognitive strategies, whether automatically or intentionally but it may not always work to our advantage. This is a hot topic of research and it will be interesting to watch this space as we learn more about how our brain hosts these algorithms for introspection and how this relates to disease and well-being.