Effectiveness of virtual simulation-based pre-learning and the mediating role of metacognition in pharmacokinetics laboratory education

BACKGROUND: Blended 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. METHODS: A 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. RESULTS: Compared 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. CONCLUSIONS: These 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.