The Metacognitive Analysis Project

The University of Rochester School of Medicine & Dentistry’s Graduate Medical Education Office and the Warner School of Education & Human Development have been awarded a 2026 Josiah Macy Jr. Foundation Catalyst Award for Transformation in Graduate Medical Education for The Metacognitive Analysis Project. Designed in late 2023, with pilots conducted in 2024-25, this multi-year collaborative initiative aims to optimize resident and fellow performance in high-stakes evaluations through a biopsychosocial lens. 

The project addresses the complex challenges faced by trainees whose performance in high-stakes evaluation may not fully reflect their knowledge and capabilities. Clinical training often occurs in high-pressure, evaluative spaces where learners’ performance is impacted by biological factors (e.g., anxiety), psychological factors (e.g., mindset, self-efficacy), and socio-cultural factors (e.g., bias, stereotype threat). By investigating interventions that mitigate imposter syndrome and optimize performance, we highlight critical areas for change, ensuring that our efforts support individual growth and increase belonging and relatedness in the graduate medical education community, all of which contribute to professional identity development and career success.

This transformative work is poised to significantly impact UR Medicine and serve as a national model for advancing clinical excellence in residency and fellowship programs by equipping trainees with evidence-based strategies to bring their performance in line with their knowledge, understanding, and capabilities. Already shared nationally with other GME leaders, the project has generated interest from peer institutions seeking to collaborate and include their own trainees in future interventions. This recognition underscores the University’s commitment to innovative, equitable, and evidence-based medical education.

Beginning February 2026, the project is being led by co-principal investigators Brett Robbins, MD, professor of Medicine and Pediatrics and senior associate dean for Graduate Medical Education and Anika Simone Johnson, EdD, assistant dean of Engagement and Enrichment at Warner. Co-investigators include Kimberly Fluet, PhD, MEd, assistant professor (clinical) at the Center for Professional Development and Education Reform at Warner; Alec O'Connor, MD, MPH, professor of Medicine and program director for the Internal Medicine residency program; and Seif Nasir, MD, MPH, Pulmonary and Critical Care fellow. Residents and fellows interested in participating in the program can fill out this survey.