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Background Drawing on Donald Schön’s concepts, this article investigates the links between computer simulation training and the concepts of reflection-on-action and reflection-in-action while participating in dental and nursing trainingAim This article explores how collaborative simulation training and collaborative conventional training affect students’ reflection processes when learning to interpret radiographic images.Method This qualitative study uses interviews from 11 nursing and 18 dental students to compare the experiences of conventional training (CON-dental students) with intra-oral radiography simulation (SIM-dental students) and cervical spine simulation training (nursing students).Results The analysis showed that the simulation and conventional training influenced reflective thought processes in different ways. The SIM students concentrated on the visual information before and after they made their choices, whereas the CON students, in the absence of three-dimensional characters and reference points, focused on discussions and mutual agreements within the group to achieve a solution. The visual feedback and opportunities for manipulation provided by the simulation training encouraged the SIM-students to examine their assumptions and actions (to reflect-in-action) while solving the task. Prior knowledge served as a theoretical and methodological scheme guiding the learners’ actions and directed their reflection on their existing anatomical knowledge.Conclusions SIM and CON training provide different conditions for students’ reflective thought processes, and these differences influence how well the groups learn radiological principles.