This study investigates the effects of a competency-oriented course and the effects of feedback training on students' reflection skills. Thirty-one nursing students enrolled in a conventional course with lectures and assignments following a traditional test. Subsequently, they enrolled in a competency-oriented course, which included more performance-oriented tasks based on competencies and a performance-based assessment. In both courses, half of the students received feedback on their assignments from tutors who were trained in feedback skills (experimental group), while the other half of the students received feedback from non-trained tutors (control group). After each course, all students wrote a reflection report. Results show that students' reflection reports after the competency-oriented course were of a higher quality than the reports after the conventional course. Contrary to our expectations, the quality of the reflection reports of the control group (students supervised by non-trained tutors) was significantly higher than the quality of reflection reports of the experimental group (students supervised by trained tutors). This study shows that a competency-oriented design of courses enhances students' reflection skills, but that the training in feedback skills needs to be reconsidered. (Contains 3 tables.)