Document Type (Journals)

Original Research


Efficient and effective occupational therapy curricular and course design is essential to develop competent and reflective practitioners. The intentional use of metacognitive strategies could improve the development of higher-order thinking and learning outcomes. The study explored the use of metacognitive strategies to improve learning and higher-order thinking in students within occupational therapy higher education. A targeted search for occupational therapy journals only was the primary method to identify studies. Arskey and O’Malley’s (2005) five-stage framework guided this scoping review. All studies demonstrated some aspects of metacognition, this included thinking about their learning, reflection, self-assessment, or sense-making. Through the PRISMA process, the initial search yielded 260 studies; 27 duplicates were removed for a remaining total of 233 studies. Thirteen articles were included in the final study. The identification of the studies’ purpose, pedagogy, metacognitive strategies, and the level of Bloom’s taxonomy for the strategies was included in the analysis. Written reflection, peer-to-peer debate, self-directed learning, critical thinking, self-assessment, and reflection observation were the metacognitive strategies described in the articles. The metacognitive strategies were not specific to a pedagogy. Rather the strategies varied in use; however, all focused on learning outcomes to develop higher-order thinking skills and life-long learners. The selected studies reported improved learning outcomes and described metacognitive strategies. Transparency and intentionality in occupational therapy higher education related to metacognition may improve learning outcomes leading to practitioners whose self-reflection and critical thinking improve client and system outcomes.


Monica L. Robinson, OTD, MS, OT/L, BCMH, FAOTA is Clinical Associate Professor at Ohio State University. Dr. Robinson applies innovative educational practices in her teaching including using metacognitive strategies in an active learning environment, providing inter-professional educational opportunities, and the use of simulation in education to bridge the gap between the classroom and the clinic.

Christine Kroll, OTD, MS, OTR, FAOTA is Assistant Professor at the University of Indianapolis. As a doctoral capstone coordinator, Dr. Kroll uses various active learning and instructional tools, developing critical reflection skills, in addition to encouraging learners to develop self-directed learning skills and their emergent professional identity.

Emma Sabransky, OTD, OTR/L is Lecturer at Ohio State University. Dr. Sabransky’s capstone was centered on metacognition and curricular design. Dr. Sabransky applies metacognitive strategies within her teaching and curricular design, providing opportunities for active learning and clinical application as related to adult physical rehabilitation.

Declaration of Interest

The authors report no declarations of interest.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.