The purpose of this study is to test the use of generating self-explanations in nursing education as it relates to student academic achievement in theoretical nursing courses. With the study being built upon a framework of cognitive constructivism, a mixed methods approach was used to examine the academic achievement of associate degree nursing students in a community college in northeast Texas. Unit exam grades and final exam grades were examined in two integrated theoretical nursing courses over the course of one semester. Demographic variables were considered, along with the semester of nursing school in which the student was enrolled. The quantitative portion of the study examined the amount of self-explanations generated as it related to academic achievement on unit exams and the final exam through a repeated measures approach. It also examined whether the semester of nursing school in which the participant was enrolled impacted the exam scores when generating self-explanations. While quantitative results yielded no significance, this non-significance and mean exam scores demonstrated that generating self-explanations can indicate knowledge retention and produce similar results to standard multiple-choice practice questions not-requiring self-explanations. Qualitative inquiry produced descriptive data, which highlighted four major themes and points of discussion including (a) activity design, (b) individual learners, (c) method of self-reflection, and (d) theory and practice. These qualitative data points augmented the quantitative results and provided valuable insight into the use of generating self-explanations in nursing classrooms and for areas of further research. With consideration given to quantitative and qualitative analysis, generating self-explanations should be considered as a tool to utilize in nursing classrooms.