Abstract
Background: An exam wrapper is a structured debriefing questionnaire designed to help students understand examination performance and develop improvement strategies.This mixed-methods pilot study sought to examine its impact on students' metacognitive skills in a fundamentals nursing class and to assess student perceptions of its usefulness. Method: Metacognition was assessed using the Metacognitive Inventory for Nursing Students. Quantitative data were analyzed using the nonparametric Friedman test. Qualitative data were taken from four focus groups. Results: Students who used the exam wrapper throughout the semester demonstrated significant improvement in metacognition over time (p = .014). Focus group data revealed that students did not find the exam wrapper to be helpful. The analysis revealed three themes: Reliance on Faculty, Overlap With Established Self-Regulated Learning Strategies, and Difficulty in Answering Exam Wrapper Questions. Conclusion: Although students may not perceive this tool as useful, those who repeatedly used it over time had increased metacognition.