There has been a shift in higher education in Europe since the turn of the millennium, from a teacher-centered, knowledge-dissemination educational approach to a student-centered approach that is more focused on learning experiences [42]. The number of students enrolled in higher education has increased, as has the diversity of the students, including in relation to age. There has also been an enhancement in the technology used in health care and nursing education and an increase in the quantity of the information being taught. To manage these challenges, teachers in nursing education are adopting new ideologies that are more focused on student-centered learning [44].

The history of nursing education started with Florence Nightingale, who opened a nursing school in London in 1860, at which the nursing students were expected to fulfill the Victorian female ideal of the time—to be faithful, loyal and submissive [18]. The Nightingale Home and Training School for Nurses was dedicated to communicating the philosophy and practice of its founder and patron, Florence Nightingale. Later, nursing education was administered at universities, in the United States (US) as early as 1909. In other countries, such as Sweden, nursing education became integrated into universities about 70 years later, in 1977. This transition to universities occurred, in part, because of the view that the prior nursing training was too vocational in nature and the educational methods did not challenge the students enough [10]. The transformation to universities meant a change in nursing education from being occupational preparation to being an educational program based on research; thus, nursing became an academic subject. Nursing education now aims to develop students’ self-awareness, critical thinking, ability to initiate change and ability to fulfill a professional role [18].

To support nursing students’ learning there is a need to understand how adults learn and what conditions support efficient learning strategies. Adult students are better able to take ownership and responsibility for their own learning, with the intrinsic motivation to learn for their own personal and professional growth [42]. Learning does not stop at adulthood and the concept of andragogy—helping adults to learn—has become more accepted and contains many different learning models. Learning should not only be to remember something and being able to recite it later, as this represents surface-level learning. Learning in higher education should also be deep, giving students a real understanding of the content [33]. According to Marton and Booth [33], the pattern of variance and invariance in the object of learning, as it is experienced by students, is the secret to learning. When students learn something, it leads to a transformation of their experience of the world [33].

Since the 1990s, research in pedagogy has become more focused on student learning and less on the teacher’s perspective [42]. Despite this change there is still no uniform definition of “student-centered learning,” but within this method, according to Rege Colet [42], students learn through social interaction and peer teaching, within learning partnerships. According to the Standards and Guidelines for Quality Assurance in the European Higher Education Area (ESG), students should be active in creating the learning process [8]. They should be able to influence their own learning, because when students are expected to stay silent, they tend to feel disempowered and to distrust their own knowledge [37].

Despite research showing the benefits of student-centered learning, much of nursing education is still focused on the acquisition of knowledge and skills in a teacher-centered way instead of a student-centered way [30]. Students need to be involved in co-creating learning plans to foster mutual respect between teachers and students, as this gives students greater motivation and a better understanding of the content of nursing education [7]. The project Quality and Safety Education for Nurses (QSEN; QSEN Competencies, n.d.) described six competencies that students in nursing education are required to learn: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety and informatics. The core competencies seek to clarify what is required of nurses’ education to achieve high quality health care [28]. Disch [7] drew a parallel between the first competency, patient-centered care and student-centered learning: just as patients should be respected and involved in their care, students should be respected and involved in their studies and just as help is provided to patients to enhance their health literacy, a system should be in place to support students to develop their curricular literacy.

Teachers in nursing education are now often encouraged to use student-centered learning to meet the pedagogical requirements of the 21st century. There is an increasing number of students in nursing education classrooms, including students with more diverse needs and students of all ages. There is also a need to manage an increasing amount of scientific information in nursing education. To be able to practice student-centered learning and to adhere to research and policy documents, there is a need to further clarify the meaning and use of student-centered learning. Without knowing what student-centered learning involves, it is not possible to practice, evaluate, or further develop the concept in nursing education.