Nurse educators are charged with teaching student nurses how to become self-aware and to use this knowledge therapeutically and in leadership activities. Self-awareness has been widely accepted as an important part of contemporary nurses' repertoire of skills and has been said to be an important factor in a successful nurse-patient relationship. It has been identified as a factor in empathy, supporting the notion that self-awareness leads to a gentler way of being and compassion results. However, there is a lack of empirical evidence related to how students actually develop self-awareness within the context of nursing education. This qualitative study focused on describing the elements of who, what, where, when, and how which influence the development of self-awareness in nursing students. Purposive sampling was used and data collection through two in-depth, face-to-face, audiotaped interviews continued until saturation occurred. Guided by naturalistic inquiry and interview research, ten baccalaureate nursing students described how they developed self-awareness as part of their nursing education program and identified the contributing contextual features. Through content analysis categories of external and internal influences on self-awareness development within the context of nursing education emerged. The process of self-awareness development was identified as occurring within the context of both interpersonal and intrapersonal interactions. External factors which influence self-awareness development include socially and emotionally significant relationships, facilitative actions of others, transformative events, and pedagogy. Internal factors that emerged include religion/spirituality, and personality/developmental issues. These findings have heuristic value for enhancing self-awareness development within the context of nursing education. The nurse educator can use these findings to understand the influencing factors (internal and external), and the best pedagogical approaches to facilitate the process.

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