A causal model of metacognitive awareness in integrated flipped learning among Iranian medical sciences students

Introduction: Metacognitive awareness underpins self-regulated learning in medical education and may be shaped by how students manage motivation, cognition, and emotion in technology-supported designs such as integrated flipped learning. This study tested a hypothesised pathway model of factors associated with metacognitive awareness among medical sciences students. Method The study population comprised medical sciences students enrolled across affiliated campuses at Shiraz University of Medical Sciences (N = 1,432). Using cluster random sampling and a standard sample-size determination approach, 380 students were selected for analysis. Data were collected using standardised self-report instruments measuring metacognitive awareness, mindfulness, goal orientation, cognitive emotion regulation, metacognitive beliefs, academic self-efficacy, and need for cognition. Results Data were screened and summarised in SPSS; the hypothesised model was tested using path analysis in AMOS and evaluated using standard goodness-of-fit indices. The final model fit the data very well and indicated that metacognitive awareness was linked to metacognitive beliefs, need for cognition, and cognitive emotion regulation both directly and indirectly through academic self-efficacy, mindfulness, and goal orientation. The model explained a meaningful proportion of variance in metacognitive awareness and academic self-efficacy. Conclusion Overall, the findings point to practical levers in integrated flipped learning: strengthening academic self-efficacy, supporting adaptive emotion regulation, and cultivating students’ engagement with effortful thinking, alongside metacognitive beliefs, may help develop metacognitive awareness in medical sciences education.