Contents lists available at ScienceDirect Nurse Education in Practice journal homepage: www.elsevier.com/locate/nepr Original research Challenges nurse educators experience with development of student nurses’ clinical reasoning skills Angeline van Wyngaarden, Ronell Leech * , Isabel Coetzee Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa ARTICLE INFO Keywords: Clinical reasoning Nursing education Student-centred teaching ABSTRACT Traditional teacher-centred teaching strategies do not always facilitate the development of desired clinical reasoning skills required for nursing practice. A multiphase study was conducted to facilitate a process of change towards improving educational practices in order to promote the development of undergraduate student nurses’ clinical reasoning skills. The study was conducted at a military nursing education institution. This paper reflects on Phase 1, where a descriptive, qualitative study was conducted to explore the challenges nurse educators experienced in utilizing teaching and learning strategies that could promote the development of clinical rea- soning skills in undergraduate student nurses. Unstructured interviews were conducted with 16 nurse educators who were selected purposively. Interviews were recorded, transcribed and data were analysed for content. The findings indicate that the clinical learning environment, the military environment, and various role players in the environment are instrumental in nurse educators not utilizing educational practices that promote the development of clinical reasoning skills in un- dergraduate student nurses. Addressing nurse educator challenges and empowering them with the means, opportunity and skills to utilize student-centred teaching and learning strategies may contribute to the development of undergraduate student nurses’ clinical reasoning skills. Raising awareness of challenges nurse educators experience in implementing student-centred facilitation of learning can assist in developing strategies to ensure nurse educators become more student-centred in their teaching. 1. Introduction Due to increasingly complex clinical settings, nurses worldwide are required to provide safe, reliable patient care and as a result must be able to reason clinically (Kavanagh and Szweda, 2017). Clinical rea- soning is an essential component of competence in clinical practice. However, some traditional teaching and learning strategies do not al- ways facilitate the development of desired clinical reasoning skills (Levett-Jones et al., 2010). Clinical reasoning is fundamental to nursing practice but is challenging to teach and learn because it is complex, tacit and invisible to students (Delaney and Golding, 2014) and ac- cording to Levett-Jones et al. (2010), requires different teaching and learning strategies. Nursing education in the classroom has traditionally focused on teacher-centred strategies consisting mostly of the lecture method of information transfer (Ellis, 2016). Thus, learning is merely the mem- orization of indisputable facts and standard problems (Mthembu et al., 2014) and students become passive receivers. Nursing education must move away from teacher-centred, content laden classrooms and include student-centred strategies that promote clinical reasoning (Shellenbarger and Robb, 2015). Various authors (e.g. Ellis, 2016; Mthembu et al., 2014; Schweisfurth, 2011; Shellenbarger and Robb, 2015) advocate a move towards student-centred teaching and learning strategies. Nurse educators play a crucial role in the development of student nurses’ clinical reasoning skills and should therefore identify and implement student-centred teaching and learning strategies (Chilemba and Bruce, 2015; Ellis, 2016). 2. Background Traditionally, clinical reasoning skills have been facilitated in clin- ical practice during student nurses’ exposure to several learning op- portunities. However, to provide student nurses with more opportu- nities to be exposed to clinical reasoning, nurse educators should identify and utilize teaching and learning strategies that introduce clinical reasoning (Gierach and Evenson, 2010; Shellenbarger and https://doi.org/10.1016/j.nepr.2019.102623 Received 1 June 2018; Received in revised form 18 April 2019; Accepted 6 September 2019 * Corresponding author. Private Bag X323, Arcadia, Pretoria, 0007, South Africa. E-mail address: ronell.leech@up.ac.za (R. Leech). Nurse Education in Practice 40 (2019) 102623 1471-5953/ © 2019 Elsevier Ltd. All rights reserved. T