Structured Reflective Sessions Enhance Knowledge and Clinical Skills in Operating Room Technology Students: A Solomon Four-Group Study Publisher Pubmed



Hassani Nia N ; Karami S ; Shahraki F ; Kohan M
Source: BMC Medical Education Published:2026

Abstract

Background and aim: Clinical education plays a critical role in preparing operating room technology students for high-stakes, procedure-intensive environments. However, traditional training methods often fail to promote deep, transferable learning and structured reflective habits. Importantly, the effectiveness of structured reflective sessions in operating room technology education remains underexplored. This study therefore aimed to evaluate whether structured reflective sessions improve theoretical knowledge, practical skills, and educational satisfaction among operating room technology students. Materials and methods: We conducted a Solomon four-group quasi-experimental study to separate the effects of the reflection-based intervention, pre-testing, and their interaction. Sixty undergraduate students in the 3rd and 5th semesters were assigned to four groups (intervention with pre-test, control with pre-test, intervention without pre-test, control without pre-test). The intervention used Gibbs’ six-stage model and comprised a 2-hour introductory workshop, weekly scenario-based analyses and guided small-group discussions over six weeks, and individual reflective journaling during clinical placements. Data were collected with a validated 20-item MCQ, Direct Observation of Procedural Skills (DOPS) checklists, and a standardized satisfaction questionnaire. Statistical analyses included paired and independent t-tests, ANCOVA (to adjust for baseline scores), and two-way ANOVA (to test pre-test × treatment interactions). Results: Participants in the intervention groups showed significantly higher post-test MCQ scores (mean = 17.46 vs. 12.86; p < 0.001) and higher DOPS scores (mean = 88.8 vs. 53.0; p < 0.001) compared with controls. Educational satisfaction was also greater in the intervention arm (mean = 78.35 vs. 70.97; p < 0.001). Solomon-design analyses indicated that these gains were attributable to the reflective intervention and not to pre-test sensitization. The intervention produced a large effect on clinical experience scores (partial η² = 0.41). Conclusions: Structured reflective sessions, delivered via Gibbs’ reflective cycle, significantly enhance theoretical understanding, psychomotor performance, and learner satisfaction among operating room technology students. We recommend integrating structured reflective practice into clinical curricula to strengthen the depth and sustainability of professional learning in high-complexity clinical settings. © The Author(s) 2025.