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Medical students struggle to put into practice communication skills learned in medical school. In order to improve our instructional designs, better insight into the cause of this lack of transfer is foundational. We therefore explored students’ cognitions by soliciting self-evaluations of their history-taking skills, coined ‘Judgements of Satisfaction (JOSs)’. Our cognitive-psychological approach was guided by Koriat’s cue-utilisation framework (1997) which rests on the assumption that internal and external cues inform learners’ metacognitive judgements, which, in turn, steer their actions. Judgements based on unsuitable cues will cause ineffective behaviour. 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