The Effect of Daily and Weekly Reflection on Nursing Students’ Critical Thinking Disposition: A Quasi-Experimental Study

Introduction: Critical thinking, defined as the purposeful, self-regulatory judgment involving interpretation, analysis, evaluation, and inference, is a fundamental requirement for education in the healthcare field. Reflection, a metacognitive process that promotes self-awareness and deeper understanding of experiences, is regarded as one of the key strategies that enhances critical thinking disposition by fostering motivation and habitual application of these skills. Objective: This study aimed to evaluate the effects of daily versus weekly reflection on the critical thinking disposition of nursing students, including its dimensions of engagement, innovativeness, and cognitive maturity. Methods: This quasi-experimental study with a pretest-posttest design was undertaken at Birjand University of Medical Sciences, Birjand, Iran in 2023. Participants (n = 48; 24 per group) were recruited via census sampling method and randomly assigned into two daily and weekly reflection groups. The intervention was conducted during four weeks of clinical training. Data were collected through a demographic information questionnaire and Ricketts' critical thinking disposition questionnaire. Results: No statistically significant differences were observed between the two groups concerning the mean scores for overall disposition towards critical thinking (p = 0.673, Cohen's d = 0.12) and for each of its dimensions: engagement (p = 0.740, Cohen's d = 0.08), innovativeness (p = 0.281, Cohen's d = 0.22), and maturity (p = 0.652, Cohen's d = 0.10) both before and after the intervention. Mean scores slightly increased in both groups post-intervention (daily: +3.2, 95% CI [1.5, 4.9] ; weekly: +2.8, 95% CI [1.0, 4.6]), though not significantly. Conclusion: Considering that the mean score of critical thinking disposition and each of its dimensions after the 4-week intervention in the two groups had no statistically significant difference, therefore, it is suggested to investigate the long-term effect of daily and weekly reflection in future studies.