Objective To explore the effects of a reflection sheet on cooperative ability improvement of endoscopic nurses. Methods We designed a reflection sheet including general information of the patient,brief medical history,preoperative discussion,preoperative preparation,cooperation problems during operation,reasons analysis and improvement measures,comments by senior nurses and head nurses,and reports and reflections of nurses. Eight nurses who had been working in the Endoscopy Center for less than 2 years were selected and they were asked to fill in the reflection sheet after the complicated operation especially those involving new materials and attachments. The head nurses summarized and analyzed the reflection sheet,and carried out the training and guidance for the nurses. This study used self-developed questionnaires investigating the nursing quality of endoscopic surgery and doctors' satisfaction with the nurses' cooperation before and after the intervention used. Results After the intervention,the nursing quality of endoscopic surgery was higher than that of before（t=6.808,P<0.001）. Doctors' satisfaction with the cooperative nurses' professional skills was also higher than that before the intervention（t=7.539,P<0.001）.Conclusion The application of a reflection sheet can improve the nursing quality of endoscopic surgery for digestive endoscopy nurses,and improve cooperation with doctors to complete endoscopic surgery,and increase doctors' satisfaction with nursing work.