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This study investigated how students' cognitive load patterns related to their self-regulated learning (SRL) and performance. One hundred and eleven medical students were required to accomplish a diagnostic task in a computer-based learning environment. The metacognitive aspects of SRL were reported by students at different points during the task, and cognitive load was rated after students finished the task. We extracted SRL behaviors from system logfiles, and students' performance was measured as diagnostic accuracy, which indicated whether they achieved an accurate diagnosis. A two-step cluster analysis was conducted to identify students’ cognitive load patterns based on their perceived intrinsic, extraneous, and germane load. We found three cognitive load patterns: knowledge builders with a low-level intrinsic and extraneous load but high-level germane load, task-loaded learners with a high-level …