Analysis of Spatial and Metacognitive Performance in First-Year Health Sciences Students

This study examines spatial metacognitive monitoring in health sciences students. This process is essential in many diagnostic judgments, as it involves interpreting images together with the level of confidence in such interpretations. We analyzed how confidence, item difficulty, spatial ability, and gender influence calibration (the accuracy of confidence judgments) and bias (the directional deviation of confidence judgment) in a task that assesses the ability to visualize cross-sections. In addition, we examined performance across all visuospatial tasks administered. A total of 322 students completed three tests (cross-sections, visualization, and mental rotation), providing confidence judgments after each item. Results showed that greater spatial ability predicted better calibration and lower overconfidence, whereas higher item difficulty reduced calibration accuracy; this effect was moderated by spatial ability. Significant gender differences emerged: women showed lower calibration error, although men were more likely to achieve perfect calibration. In the performance models, both confidence and visualization ability strongly predicted accuracy. Interactions indicated that spatial ability buffered the negative effects of difficulty and that confidence predicted performance mainly for easier items. Spatial ability is highlighted as a key moderator of metacognitive accuracy, and its training may enhance diagnostic reasoning, thereby contributing to improved patient safety in future professional practice.