• Su Hui Valynn Wong and Yanika Kowitlawakul.
• Ward 5A-General Medicine, Nursing Department, National University Hospital/National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. Electronic address: e0007169@u.nus.edu.
• Nurse Educ Today. 2020 Dec 1; 95: 104600.

AimThe aims of this study were to explore year two nursing students' perceptions toward critical thinking and clinical reasoning and to identify the barriers faced by the students in developing critical thinking and clinical reasoning.BackgroundCritical thinking and clinical reasoning are core competencies emphasized in nursing practices. Nursing students are required to develop and practice these skills throughout their nursing programs to graduate as competent nurses. However, recent studies still report a lack of critical thinking and clinical reasoning in nursing students and fresh graduates. Hence, it is important to recognize the perceptions of nursing students and the barriers that they face in developing critical thinking and clinical reasoning skills.MethodsAn exploratory descriptive qualitative study design was adopted. Twenty nursing students were recruited from a university in Singapore. Individual face-to-face interviews, using semi-structured questions and an interview guide, were conducted in the academic year 2018/2019. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyze the data.ResultsSeven themes were emerged, namely: 1) essentials for nursing practices, 2) linking theory to practice, 3) individual thought process, 4) stimulating strategies, 5) classroom environment, 6) clinical environment, and 7) students' attributes. Nursing students perceived critical thinking and clinical reasoning as essential for nursing practices and described these skills as linking theory to practice. Strategies such as simulation, case studies, real clinical experiences, and guidance from clinical instructors/preceptors were found to stimulate critical thinking and clinical reasoning for the students. Barriers to developing critical thinking included classroom environments, such teaching methods and student-to-tutor ratios, ward environments/cultures, and students' attributes/attitudes toward learning.ConclusionThe findings provided areas for improvement in the current nursing education and practices to better support nursing students in developing critical thinking and clinical reasoning skills.Copyright © 2020 Elsevier Ltd. All rights reserved.

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