Reflective writing to promote metacognition in physiology education

Reflective writing has a role in teaching metacognition and self-regulated learning within physiology and related biological sciences education. Metacognitive skills, such as self-assessment, strategy planning, and reflection, are linked to improved learning outcomes, yet many students lack these skills upon entering physiology and pathophysiology courses. The purpose of this review is to summarize the evidence of the benefit of reflection as a metacognitive exercise. Reflective writing, including informal reflections, exam wrappers, and formal assignments, encourages students to evaluate their learning strategies and performance. Evidence suggests that these practices increase self-awareness, interest, professional and clinical skills, and critical thinking, albeit improvements in multiple-choice exam scores are mixed. Portfolio-based assessments and institutional tools further support the development of reflective skills for academic and career advancement. Overall, integrating reflective writing into biological sciences and professional programs helps students grow in their metacognitive learning, develop clinical competencies, and prepare for lifelong learning.