The purpose of this study is to examine the effects of the reflection journal on nursing students meta-cognition, learning flow, and self-leadership in the health assessment skills course. The subjects of this study were 95 nursing college students from G city. The data collection before the reflection journal is from August 28 to September 1, 2017, after the reflection journal is made, from December 15, 22 days. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation coefficient using SPSS 21.0program. The meta-cognition and self-leadership were significantly higher. Meta- cognition showed a significant positive correlation with learning flow and self-leadership, and learning flow had a significant positive correlation with self-leadership. Meta-cognition and self-leadership showed higher learning flow. Therefore, it suggests the development and application of the education program that can improve the meta-cognition and self-leadership.