This study examined whether confirmation questions enhanced the knowledge required for clinical reasoning among occupational therapy students. Administered through an LMS, the confirmation questions followed a drill format, allowing unlimited attempts. After each quiz attempt, students reviewed their individual scores. The results indicate a correlation between the number of access logs and confirmation question scores, and between confirmation question scores and clinical reasoning task scores, particularly among students whose previous course performance was below average. These findings suggest that using confirmation questions as a preparatory task can effectively supplement the knowledge necessary for clinical reasoning, especially among students with lower academic performance.

The relationship between reflection and university students’ learning outcomes has been examined mainly in professional education courses and experiential or practical training courses, however, the measurement of reflection has not been elaborated on. This study aimed to organize the characteristics of the reflection process model, develop a scale to measure reflection that can be applied to lectures and seminars, and examine the link between reflection and learning outcomes, such as academic performance and a sense of acquiring abilities. We used factor analysis based on data from 942 university students and developed a reflection scale consisting of three subdimensions: “recall and analysis of content,” “recall and analysis of activities,” and “utilization.” We used cluster analysis to identify six types of reflections based on these three subdimensions. It was shown that students who actively engaged in reflection tended to have a higher sense of acquiring abilities than the other types.