ArticleBMC medical education2026
Effectiveness of virtual simulation-based pre-learning and the mediating role of metacognition in pharmacokinetics laboratory education.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundBlended learning integrating virtual simulation (VS) and hands-on components is promising for enhancing medical/pharmacy knowledge and skills. However, consensus on effective integration strategies and mechanisms remains lacking. This work aimed to explore the effect of integrating VS-based pre-learning in a pharmacokinetics laboratory module on pharmacy students’ learning performance, and whether metacognition mediated this effect.
methodsA quasi-experimental study was conducted among 64 third-year pharmacy undergraduates at Wuhan University of Science and Technology, who were divided into an experimental group (n = 32) and a control group (n = 32). Students in the control group received traditional teaching steps, including routine pre-class preview, in-class lectures, and hands-on experiments in rabbits. While the experimental group replaced routine preview with VS-based pre-laboratory self-learning. Metacognition Questionnaire-30 (MCQ-30) was utilized to assess students’ metacognitive levels before and after the interventions. VS-based pre-learning scores in the experimental group were auto-recorded by the platform. Post-intervention learning performances were measured via knowledge test after class, experimental operation and design tests, alongside a learning satisfaction questionnaire. Bias-corrected non-parametric percentile Bootstrap test was employed to analyze metacognition’s mediation effect.
resultsCompared with routine preview used in the control group, VS-based pre-laboratory self-learning significantly enhanced the experimental group’s scores in theoretical knowledge, experimental operation, and design tests (all p < 0.05), with Cohen’s d values ranging from 0.551 to 0.678. After controlling for covariates, each one-unit increase in online VS-based pre-learning performance correlated with a 0.324-unit increase in theoretical knowledge (p = 0.003), 0.304-unit in experimental operation performance (p = 0.002), and 0.550-unit in experimental design ability (p = 0.000), respectively. Although no significant difference in total MCQ-30 scores was observed between groups, Bootstrap analysis revealed significant mediating effects of MCQ-30 scores between VS-based pre-learning and hands-on learning performance, with effect sizes of 0.1785 (95% confidence interval [CI]: 0.0491, 0.3398), and 0.1659 (95% CI: 0.0091, 0.4385) for theoretical knowledge and experimental design, accounting for 55.06% and 30.20% of the total effects, respectively.
conclusionsThese data suggest that integrating VS-based pre-learning into pharmacokinetics experiments enhanced pharmacy undergraduates’ learning performance in hands-on laboratory classes, with this effect partially mediated by metacognition.
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