Critical pedagogy is the conception of education as praxis, which allows to reach the emancipation of the oppressed classes by means of the awareness that is achieved when questioning the immediate social reality (Freire, 2005). In this context, the teacher accompanies the student as an agent of social change in the construction of knowledge, from the analysis, comprehension, interpretation, transformation and intervention of problems in the community of which they are a part of (Ramírez, 2008).

As an emerging pedagogy in nursing, Piña and Amador (2015), Gordon (2010) and Rozo (2002) propose constructivism as a basic transformation model of the teaching-learning process based on Lev Semenovich Vigotsky (2001), who states that knowledge is elaborated individually, as a dynamic process that is transformed over time. This is related to the environment and the experience of the human being through the zone of close development, which is "the distance between the level of development, determined by the capacity to solve a problem independently and the level of potential development, determined through the resolution of a problem under the guidance of an adult or in collaboration with another more capable companion" (Baquero, 1997, p. 3). The process involves not only the learner as an active actor, but also the teacher, since teaching is given as a construction dynamic, which offers alternatives for the circular and ascending growth of the actors, by means of communication or intersubjectivity that facilitates the joint understanding of shared knowledge (Vigotsky, 2001).

From here, learning is the individual’s own process, which occurs through the interaction of mediating instruments: tools and signs. The tools are the expectations and previous knowledge of the student that transform the informative stimuli that come from the context; and the symbols are the set of signs that the same subject uses to make these stimuli their own. This process receives the name of the double education law, since the knowledge is acquired from the outside, together with the tools and then it is restructured in the inside through the symbols (Baquero, 1997).

Vigotsky develops the concept of scaffolding in which a significant adult with the help of mediators, accompanies the student in the structuring of knowledge to access new learning, creating a certain degree of autonomy and independence to learn. Teaching is oriented in a reciprocal way from the dialogue of the teacher with a group of students, where the change of roles allows to verify the level of comprehension by means of social exchange and scaffolding, while the students acquire the emotional, affective and cognitive abilities (Carrera and Mazzarella, 2001). According to Castro and Pereira (2011) and Lepiani et al. (2013), teaching in nursing from this paradigm and model leads to the teacher being an apprentice, where he is always in the search, updating and reflecting knowledge and teaching practice, which demands an increasingly serious teacher training in the field of pedagogy.

In this way, care is proposed as a teaching-learning process, "from pedagogical tools and strategies that favor the rapprochement between theory and practice, by making greater use of those that increase the visibility of nursing knowledge to provide a solution to the phenomena inherent to the discipline" (Mantilla and Gutiérrez, 2013, p. 46). This reconstructs the concept of learning from the significant adult and student’s cognitive, affective and physiological traits, as the basis for the development and incorporation of mediators, which allow the humanization of knowledge construction environments over time, starting from problematic methodologies (Paim, Lappe and Rocha, 2015).

For Castro and Pereira (2011), the care of teaching is to allow the student to grow in his own time and manner, to recognize his independence, to have tolerance for limitations and ramblings, to be honest, sincere, and to believe in the student's potential as a necessary condition for learning. The processes of planning and organization, in relation to the pedagogical action of the teacher, contribute to a better teaching in nursing from the coherence of humanized care. This is how the incorporation of reflective strategies allows students to understand practice from theory, so that the knowledge acquired in the classroom takes on meaning and significance in the teaching process, which the teacher proposes as a complementary agent that guides and accompanies, and abandons reductionism and the transmission of knowledge (García, Guillen and Acevedo, 2011).

Henao, Rodríguez and Quimbayo (2010) conclude that the educator, as the mediator of the teaching-learning process, must approach the student with a methodology through which they can both learn to learn and direct his practice towards the acquisition of concepts that generate new academic, personal, social and civic attitudes. This implies that for nursing to transcend the content beyond imparting subjects, as "the task that is considered essential in a teacher is that of teaching" (Porlán, 1987, p. 65), so it is possible to facilitate learning from research in the classroom in which inquiry processes are presented as unpredictable for knowledge quality that facilitates meaningful teaching.

To achieve this process, each teacher must recognize that the student is not a receiver of messages, but an individual being with their own needs. Furthermore, variables such as the environment, the degree of cognitive development and the semantic structure with which they interpret reality all influence the student’s learning, which teachers must know in order to adapt their teaching practices and leave homogenized groups aside (Porlán, 1987; García, 2005; Ospina, 2006).

Nursing, as a dynamic profession and in response to the paradigm shift, proposes Patricia Benner's Model of Clinical and Ethical Wisdom Care in Nursing Practice. In this, the process of nurse training is based on competencies that will be reflected in their professional and personal practice, by generating cognitive, affective, behavioral and behavioral skills that allow them to translate theory into practice, according to the stage in which the student is at.

In the same way, it conceives the person as an complete being with capacities and potentialities that are developed with the interactive experience with others. In this sense, it establishes the relationship of simultaneity of the teacher as mediator of the interactive construction of knowledge with the student, based on the needs and strengths as active beings of a continuous process that transcends from various learning strategies (Benner cited in Carrillo et al., 2013; Molina and Jara, 2010).

Benner (cited in Rauner, 2007) proposes the approach to real and meaningful learning, through the regulation of the development of competences that allow the student to take his abilties from a beginner state to an expert state through the construction of practical knowledge. For this, proposals are generated around learning theories that the new nursing education should be appropriate, in order to continue the development of a transforming path. These theories can be punctuated in the following way:

Problem-Based Learning (PBL) is defined as "a learning method based on the principle of using problems as a starting point for the acquisition and integration of new knowledge" (Barrows quoted by Granero, et al., 2011, p. 30). It focuses on the student, who will develop communication skills, expression and critical thinking around the reconstruction of knowledge of the discipline from understanding, prior knowledge and context when facing real situations (Spencer, 2003). Similarly, Giribet and Medina (2014) propose that the problematized situation should correspond to real life, so that it allows the construction of explanatory hypotheses, as well as the identification of learning needs that lead to be solved as a teacher-student group, to achieve the previously established objectives.

Collaborative Learning is defined as "the set of instructional methods for application in small groups, training and development of mixed skills, where each member of the group is responsible for their learning as well as that of the other members in the group"(Duran quoted by Acevedo 2009, p.58). This type of learning in the nursing profession involves staging coexistence according to the values promulgated by the discipline such as autonomy, respect, responsibility and individual and group beneficence around the collective construction of new knowledge (Acevedo, 2009).

Evidence-Based Learning (EBL) is the critical, reflective and propositional use of information derived from research that leads to the validation of care and makes decisions regarding the need for change in practice, based on scientific substantiation. This proposal allows the inclusion of technology as a tool that modifies the cognitive and conceptual structures of the teacher and the student, based on the critical thinking which must be applied in each systematic review that is undertaken (Cano, 2008). For Eterovic and Stiepovich (2010) this learning "consists of a five-stage method, namely: formulation of the question that derives from the observed problem; search for the best answer in the best sources of information; critical evaluation of the evidence found; implementation of evidence in practice, when considering the preferences of users; and evaluation of the consequences resulting from the applied intervention" (p. 10).

Experiential Learning is a concept developed by John Dewey (quoted in Pineapple and Amador, 2015) who proposes that "one learns by doing and incorporating the reflection on it, without this meaning the reduction to a repetitive and unreflective doing" (p.154). This learning integrates analysis, synthesis, comparison, and analogies that are presented in the various scenarios first proposed by the teacher and then by the student, who is responsible for his or her learning as an autonomous subject and not just a spectator of what is happening (Niño, Vargas, and Barragán, 2015).

The aforementioned types of learning respond to the significant process proposed by Ausubel (cited in Bernal and Ponce, 2009), which occurs as "a complex, systematic and organized phenomenon that includes the active restructuring of the perceptions, ideas, concepts and schemes that the apprentice possesses in his cognitive structure" (p. 35). Thus, the rethinking of educational practice in nursing is based on experiences, ideas and previous information, which will be integrated for the construction of new concepts and allow the transformation of reality from critical and reflective thinking, which demonstrates the usefulness of learning (López, Cardó and Moreno, 2011; Barriento, et al., 2009).

In coherence with significant learning, strategies are postulated that allow the development of competences of the knowledge of being, of the knowledge and the know-how from the patterns of nursing knowledge: the empirical pattern, the ethical pattern, the aesthetic pattern, the personal pattern, the socio-political pattern and the emancipatory pattern. The recognition of these patterns allows the construction of epistemological questions about nursing care from critical questions, creative processes, integrated expressions, construction of empirical indicators from teaching, to put them into practice through the construction and analysis of the nursing situation as the lived and shared experience where the care between nurse and person cared for is enhanced (Mantilla and Gutiérrez, 2013).

Other strategies for teaching nursing that can be used are: concept maps, documentary analysis, systematic review, poetry, mimics, dramatizations, creative writing, sculptures, drawings, bulletins, decoration, artistic projects and group discussions as means to stimulate the critical and reflective process (Moura and Mesquita, 2010).

According to Niño, Vargas and Barragán (2015), clinical simulation is a methodology that favors the direct participation of the student in learning processes. The student is the main protagonist of the scenario, in which guides are constructed that involve clinical situations and integrate previous knowledge and take up new ones, to produce concepts and the achievement of previously established competencies. Alongside this strategy, information and communication technologies (ICTs) facilitate the development of metacognition processes and generate knowledge as a product of social, collaborative and explorative reflection (Boude and Ruiz, 2008).

For Tovar, Argote and Ocampo (2011), the use of ICTs in education means redefining the concept of flexibility in terms of physical and intellectual presence, productivity, creativity, innovation, time periods and tools made available to the student, who is autonomous and author of the knowledge that can produce and expand from multiple sources, where care is built from interactive perspectives of national and international character. Thus, teachers and students reflect on the world reality, through positions that seek alternatives to the problems encountered.

Now, with the objective of giving visibility to the discipline in higher education, the transforming change of the teaching-learning process begins, based on innovative pedagogical practices that promote comprehensive information through cooperation and effective communication. In this process, a critical-constructivist approach is used, the dialectic between theory and practice and practical-critical rationality, that lead the student to make decisions in a holistic way when faced with real situations. This implies an abandonment of the positivist and technological model (Triviño and Stiepovich, 2007).

Thus, the pedagogical practices of teachers must be in constant transformation based on the reflective process that they carry out with the group of students. They construct the significant learning process from the recognition of the history of the involved subject, the perception of the situation, the objectives, alternatives and resolution strategies that lead to the appearance of alternative conceptions in the role of the teacher. This changes with the vertical form of teaching and stimulates the power of creativity, affectivity and the reality of understanding in the student (Agramonte et al., 2006; Pereira and Tavares, 2010).