Background: Clinical reasoning is the ability to reason as a clinical situation changes and is an
essential component of competence in nursing practice. However, some traditional teaching
and learning strategies do not always facilitate the development of the desired clinical
reasoning skills in nursing students.
Problem statement: Nurse educators at a military nursing college in Gauteng are
predominantly utilising traditional teacher-centred teaching and learning strategies. The
concern is that if students are predominantly taught by means of traditional teacher-centred
strategies this may not contribute to the development of the desired clinical reasoning skills
required for nursing practice. To improve educational practices to promote the development of
student nurses' clinical reasoning skills, the researcher conducted an action research study.
Aim: The aim of the study was to facilitate a process of change towards improving educational
practices in order to promote the development of undergraduate student nurses' clinical
Methodology: Action research was used to conduct the research study by means of three
phases. During Phase 1: the Baseline phase, data was collected by means of unstructured
interviews with nurse educators and head of departments to explore and describe the
challenges experienced by nurse educators in utilising alternative educational practices.
During Phase 2: the Action Research Process phase, an action research group was
established to co-construct an action plan to address the identified challenges. Four action
research cycles each comprising four steps, namely plan, act, observe and reflect was
implemented. Phase 3, the Evaluation of the Action Research Process phase, evaluated the
outcomes of the action research process by means of the World Café data collection method.
Qualitative data from Phase 2 was analysed using the steps outlined in Saldaña (2013). The
activities conducted during the action research group workshops were recorded and minutes
were kept. Data from the World Café was analysed using the creative hermeneutic data
analysis method as suggested by Boomer and McCormack (2010).
Findings: The challenges encountered by nurse educators were explored and the following
four main themes emerged: educational practices; clinical learning environment; military learning environment; and role players in the teaching and learning environment. The
challenges were prioritised by the action research group into four strategies: teaching, learning
and assessment strategies; the clinical learning environment; continuous professional
development; and support and selection of students and nurse educators. An action plan was
co-constructed during Phase 2 by the action research group participants. The project was
evaluated by the action research group as successful. The action research process contributed
to the professional development of the nurse educators and resulted in the utilisation of more
student-centred teaching, learning and assessment strategies.
Conclusions: An action plan was developed to improve educational practices at the South
African Military Health Service Nursing College. The researcher also developed a conceptual
framework to promote clinical reasoning skills. Addressing nurse educator challenges in
collaboration and empowering them with the means, opportunity and skill to utilise studentcentred
teaching and learning strategies may contribute to the development of undergraduate
student nurses' clinical reasoning skills.