Abstract
[Purpose] Although non-cognitive skills have been linked to academic performance, their relevance to physical therapy students remains unclear. This study examined associations between non-cognitive skills and academic performance among Japanese physical therapy students, focusing on metacognition, motivation, professional identity, self-control, and grit. [Participants and Methods] Thirty first-year students enrolled in a four-year physical therapy program completed self-reported questionnaires. Cumulative grade point average (GPA) and GPA for required specialized courses were obtained for the first and second academic years. Correlation analyses examined associations between non-cognitive skills and academic performance. [Results] Metacognitive knowledge and professional identity were positively correlated with GPA in required specialized courses in both academic years. In the second academic year, consistency of interest (grit), self-efficacy, and study skills as measured by the Motivated Strategies for Learning Questionnaire were significantly associated with GPA in required specialized courses. [Conclusion] Metacognitive knowledge and professional identity were associated with academic performance among Japanese physical therapy students. These findings suggest that non-cognitive skills may be relevant when examining academic outcomes in physical therapy education.
Key words: Metacognition, Professional identity
INTRODUCTION
In Japan, obtaining a national license as a physical therapist requires graduating from a three- or four-year accredited training institution. Students enrolled in physical therapy courses in such institutions are expected to acquire extensive knowledge and technical skills. International studies have reported that academic performance among students in physical therapy and other healthcare training programs is a predictor of national examination scores and pass rates1,2,3). In Japan, academic performance has also been associated with student dropout rates in these training programs4). While cognitive abilities such as intelligence and academic achievements at the time of admission are widely recognized as factors influencing academic performance5), non-cognitive skills, including self-control and grit, have also recently been associated with academic achievement6).
These non-cognitive skills encompass a range of psychological and behavioral traits that contribute to learning success. In examining the relationship between various non-cognitive skills and academic performance, higher levels of motivation, for instance, have been associated with better academic performance among medical students7), and metacognition has been correlated with academic achievement8, 9). Amongst various non-cognitive skills, grit has received significant research attention. Duckworth et al.6) defined grit as a non-cognitive trait focusing on an individual’s ability to achieve long-term goals. Studies have reported its association with success in passing national licensing exams among doctoral students in physical therapy programs9). Additionally, self-control, the ability to regulate behaviors, thoughts, and emotions in line with specific goals, has been correlated with academic success10, 11). As such, these findings indicate a crucial role played by non-cognitive skills in academic performance.
However, most studies examining the relationship between non-cognitive skills and academic performance have focused on students in general university programs, whereas students enrolled in physical therapy training programs have clear professional goals from the outset, distinguishing them from students in general academic programs. In Japan, most students enrolled in physical therapy training programs are late adolescents. Erikson’s theory of psychosocial development suggests that identity formation is a critical developmental task during this period12). Progressing through coursework and clinical training, students gradually develop a professional identity related to their future role as physical therapists. Professional identity is defined as “the attitudes, values, knowledge, beliefs and skills that are shared with others within a professional group and relate to the professional role being undertaken by the individual”13). Establishing a professional identity is particularly meaningful for students in healthcare fields as it not only contributes to resolving their psychosocial developmental tasks, but can also impact their academic engagement. If students fail to develop a professional identity, their motivation to take specialized courses may decline, potentially leading to poor academic performance or dropping out.
Despite growing recognition of the importance of non-cognitive skills in academic performance5, 14, 15), no studies have specifically examined the relationship between professional identity and academic performance among Japanese physical therapy students, in addition to other non-cognitive skills. If a clear association between non-cognitive skills and academic performance can be identified in physical therapy students, it could facilitate the early detection of students at risk of academic difficulties and inform early intervention strategies. Additionally, insights from such studies could contribute to the development of educational strategies and student support programs incorporating essential non-cognitive skills. Therefore, this study aimed to clarify the relationship between non-cognitive skills, including metacognition, learning motivation, professional identity, self-control, and grit, and academic performance among physical therapy students in Japan.
PARTICIPANTS AND METHODS
This study targeted first-year students enrolled in a four-year physical therapy training program as of January 2023. Participants were recruited through email, advertisements, and verbal communication. Participation was voluntary, and students were informed both orally and in writing that their decision to participate would not affect their academic performance or evaluations. They were then asked to complete a questionnaire. Of the 86 first-year students enrolled, 30 participants (18 women and 12 men; mean age: 19.0 ± 0 years) provided informed consent and had no missing data and were included in the analysis (Fig. 1). The study protocol was approved by the Institutional Review Board of Nihon Institute of Medical Science (approval numbers: 2022018, 2023016). This study employed a longitudinal observational design using self-administered questionnaires. Participants’ background information (individual identification ID, age, and gender) was collected, and cumulative grade point average (GPA) for all courses (GPA-all) and required specialized courses (GPA-S) for both the first and second academic years were obtained from the institutional database. GPA-all encompassed both specialized subjects and foundational courses, whereas GPA-S included only specialized subjects, such as Introduction to Physical Therapy and Clinical Practice. For both measures, GPA was calculated by dividing the sum of the products of grade points and credits by the total number of credits. Non-cognitive skills were assessed by evaluating metacognition, motivation, professional identity, self-control, and grit using validated self-report questionnaires. Metacognition was assessed using the Adult Metacognitive Scale (AMS) developed by Abe and Ida16). This scale is based on Schraw and Dennison’s Metacognitive Awareness Inventory17), and consists of 28 items with confirmed reliability and validity. The items are categorized into three subcategories: “monitoring”, “control”, and “metacognitive knowledge”. Each item was rated on a 6-point Likert scale (1=“strongly disagree”, 6=“strongly agree”). Professional identity was evaluated using the Professional Identity Scale (PIS) for medical students, developed by Fujii et al18). This scale consists of 20 items rated on a 7-point Likert scale (1=“strongly disagree”, 7=“strongly agree”). Motivation was measured using the Japanese version of the motivation section of the Motivated Strategies for Learning Questionnaire (MSLQ) translated by Miyabe et al.19), originally developed by Pintrich and De Groot20). This validated scale consists of 31 items categorized into six subcategories: “intrinsic goal orientation”, “extrinsic goal orientation”, “learning value”, “perceived ability and skills”, “self-efficacy for learning and performance”, and “test anxiety”. Each item was rated on a 7-point Likert scale (1=“strongly disagree”, 7=“strongly agree”). Self-control was assessed using Ozaki et al.’s21) Japanese version of the Brief Self-Control Scale (BSCS-J)11). This scale consists of 13 items rated on a 5-point Likert scale (1=“strongly disagree”, 5=“strongly agree”) with established reliability and validity. Grit was measured using the Japanese version of the Grit Scale (Grit-J) developed by Takehashi et al.22) based on Duckworth et al.’s6) original Grit scale. This 12-item scale includes two subcategories: “consistency of interest” and “perseverance of effort”. Each item was rated on a 5-point Likert scale (1=“strongly disagree”, 5=“strongly agree”). The reliability and validity of Grit-J has been confirmed22). GPA data were collected in March 2023 and March 2024, whereas assessments of non-cognitive skills data were collected between January and March 2023. For statistical analysis, we calculated the mean scores for each participant in the three subcategories of the AMS (monitoring, control, and knowledge), six subcategories of MSLQ (value, self-efficacy, anxiety, extrinsic goal, intrinsic goal, and skills), and two subcategories of Grit-J (consistency and perseverance). The mean scores of PIS and total BSCS-J scores were also calculated. To examine the relationship between these non-cognitive skills and academic performance, correlation analyses were performed between each non-cognitive skill score and the GPAs for the first (GPA-all-first and GPA-S-first) and second (GPA-all-second and GPA-S-second) years. Data distribution was assessed using the Shapiro–Wilk test for each variable. Pearson’s correlation coefficient was applied to variables with a normal distribution, whereas Spearman’s rank correlation coefficient was used when normality was not confirmed. All statistical analyses were conducted using R version 4.4.1 (R Foundation for Statistical Computing, Vienna, Austria). The significance level was set at p<0.05.
Fig. 1.
Flow diagram of participant recruitment and inclusion in the analysis.
RESULTS
Table 1 presents the mean, standard deviation, median, interquartile range, and range for GPA-all and GPA-S in the first and second academic years, as well as for AMS, PIS, MSLQ, BSCS-J, and Grit-J in the first academic year. GPA-all-first averaged 48.0 credits (range: 46–51), and GPA-all-second averaged 38.1 credits (range: 31–41). GPA-S-first averaged 9.8 credits (range: 8–10), whereas GPA-S-second averaged 21.7 credits (range: 14–22).
Table 1. Descriptive statistics for grade point averages (GPAs) and non-cognitive skill measurements (n=30).
| Mean (SD) | Median (IQR) [range] | ||
| GPA | |||
| GPA-all-first | 2.43 (0.72) | 2.28 (1.89–3.00) [1.18–3.82] | |
| GPA-S-first | 2.80 (0.78) | 2.60 (2.20–3.58) [1.60–4.00] | |
| GPA-all-second | 2.57 (0.57) | 2.34 (2.05–3.05) [1.89–3.81] | |
| GPA-S-second | 2.24 (0.72) | 1.98 (1.61–2.85) [1.40–3.90] | |
| AMS | |||
| Monitoring | 2.95 (0.52) | 3.00 (2.48–3.27) [1.91–3.82] | |
| Control | 3.43 (0.56) | 3.56 (2.48–3.27) [2.22–4.44] | |
| Knowledge | 3.69 (0.34) | 3.75 (3.50–3.88) [3.00–4.50] | |
| PIS | 4.86 (0.93) | 5.05 (4.28–5.54) [2.05–6.10] | |
| MSLQ | |||
| Value | 5.22 (0.70) | 5.28 (4.89–5.75) [3.33–6.33] | |
| Self-efficacy | 3.20 (0.98) | 3.22 (2.71–3.82) [1.14–5.14] | |
| Anxiety | 5.42 (0.99) | 5.40 (4.45–6.00) [3.60–7.00] | |
| Extrinsic goal | 5.51 (0.78) | 5.50 (5.00–6.00) [4.25–7.00] | |
| Intrinsic goal | 4.89 (0.74) | 5.00 (4.33–5.33) [3.67–6.67] | |
| Skill | 4.31 (0.93) | 4.50 (3.67–4.67) [2.67–6.00] | |
| BSCS-J | 35.9 (6.69) | 38 .0(32.2–40.0) [20.0–46.0] | |
| Grit-J | |||
| Consistency | 3.11 (0.69) | 3.17 (2.83–3.63) [1.67–4.50] | |
| Perseverance | 2.74 (0.62) | 2.83 (2.50–3.00) [1.17–4.17] | |
SD: standard deviation; IQR: interquartile range; GPA-all: cumulative GPA in all courses; GPA-S: cumulative GPA in required specialized courses; AMS: Adult Metacognition Scale; PIS: Professional Identity Scale; MSLQ: Motivated Strategies for Learning Questionnaire; BSCS-J: Japanese version of the Brief Self-Control Scale; Grit-J: Japanese version of the Grit Scale.
Correlation analyses revealed the following significant relationships. In the first academic year, GPA-all-first showed significant positive correlations with AMS knowledge (r=0.377, p=0.039) and PIS (ρ=0.388, p=0.034). Additionally, GPA-S-first was significantly correlated with AMS knowledge (ρ=0.411, p=0.023) and PIS (ρ=0.376, p=0.040). In the second academic year, GPA-all-second showed no significant correlations (p>0.05). By contrast, GPA-S-second was significantly correlated with AMS knowledge (ρ=0.437, p=0.015), PIS (ρ=0.442, p=0.014), MSLQ self-efficacy (ρ=0.471, p<0.01), MSLQ skills (ρ=0.381, p=0.037), and Grit-J consistency (ρ=0.379, p=0.038). Table 2 provides a detailed summary of the correlation analysis results.
Table 2. Pearson’s r or Spearman’s ρ correlation analysis (n=30).
| The first grade |
The second grade |
|||
| GPA-all | GPA-S | GPA-all | GPA-S | |
| AMS monitoring | r=0.257 | ρ=0.348 | ρ=0.223 | ρ=0.311 |
| AMS control | r=0.195 | ρ=0.224 | ρ=0.059 | ρ=0.163 |
| AMS knowledge | r=0.377* | ρ=0.411* | ρ=0.247 | ρ=0.437* |
| PIS | ρ=0.388* | ρ=0.376* | ρ=0.326 | ρ=0.442* |
| MSLQ value | r=0.238 | ρ=0.352 | ρ=0.162 | ρ=0.233 |
| MSLQ self-efficacy | r=0.250 | ρ=0.297 | ρ=0.213 | ρ=0.471** |
| MSLQ anxiety | r=−0.054 | ρ=−0.098 | ρ=−0.186 | ρ=−0.242 |
| MSLQ extrinsic goal | r=−0.168 | ρ=−0.05 | ρ=−0.232 | ρ=−0.063 |
| MSLQ intrinsic goal | ρ=0.067 | ρ=0.022 | ρ=−0.040 | ρ=−0.001 |
| MSLQ skill | ρ=0.269 | ρ=0.325 | ρ=0.240 | ρ=0.381* |
| BSCS-J | r=0.119 | ρ=0.114 | ρ=0.210 | ρ=0.223 |
| Grit-J consistency | r=0.276 | ρ=0.160 | ρ=0.263 | ρ=0.379* |
| Grit-J perseverance | r=0.037 | ρ=0.071 | ρ=0.158 | ρ=0.287 |
*p<0.05, **p<0.01.
GPA: grade point average; GPA-all: cumulative GPA in all courses; GPA-S: cumulative GPA in required specialized courses; AMS: Adult Metacognition Scale; PIS: Professional Identity Scale; MSLQ: Motivated Strategies for Learning Questionnaire; BSCS-J: Japanese version of the Brief Self-Control Scale; Grit-J: Japanese version of the Grit Scale.
DISCUSSION
This study examined the relationships between non-cognitive skills assessed in the first academic year and subsequent academic performance among Japanese physical therapy students. Although several correlations reached statistical significance, their magnitude was generally weak to moderate (approximately r or ρ=0.37–0.47), based on commonly used benchmarks in the behavioral sciences23). Accordingly, the examined non-cognitive skills accounted for only a limited proportion of variance in academic performance.
Weak to moderate correlations were observed between GPA-S and metacognitive knowledge and professional identity. Similar magnitudes of association between metacognitive factors and academic achievement have been reported in previous studies involving higher education and healthcare students8). These findings suggest that the present results are broadly consistent with existing literature, while also indicating limited effect sizes. In contrast, other components of metacognition, including monitoring and control, as well as self-control, were not significantly correlated with academic performance. Previous meta-analytic research has shown that associations between non-cognitive traits and academic outcomes vary substantially across constructs and contexts24), which may partly explain the absence of consistent relationships in this study.
Significant correlations were observed primarily for GPA-S rather than GPA-all. Prior research in Japanese physical therapy education has indicated that performance in required specialized subjects is particularly relevant to academic progression and retention4). The present findings align with this perspective, although the observed associations remain modest.
Consistency of interest, a subcomponent of grit, showed a weak correlation with second-year GPA-S, whereas perseverance of effort did not. Meta-analytic evidence indicates that grit is generally weakly associated with academic performance and that its subcomponents may differ in relevance depending on context24). The present findings align with this pattern and should be interpreted cautiously.
Several limitations warrant consideration. The sample size was small, and participants were recruited from a single institution. Consequently, causal relationships cannot be inferred, and unmeasured confounding may have influenced the observed associations. As emphasized in methodological literature on observational studies, statistically significant associations alone do not establish causal effects25). Future studies using larger, multi-institutional samples and longitudinal or causal inference-oriented designs are needed to clarify the nature and direction of these relationships.
Funding
No external funding was received for this study.
Conflict of interest
The authors declare no conflicts of interest.
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