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Aim The overall aim of this thesis is to create knowledge about caring and learning as an intertwining phenomenon at a Dedicated Education Unit and how it can be developed. Approach and method A lifeworld approach, based on the phenomenological philosophies foremost derived from Husserl and Merleau-Ponty was used and carried out in lifeworld interviews and with meaning-oriented analysis in accordance with reflective lifeworld research. The participants were: 13 student nurses (study I), 11 patients (study II), 8 supervisors (study III) all from the same DEU in orthopedic care and 10 managers from various DEUs (study IV). Main findings Intertwined caring and learning is most evident in genuine encounters between students and patients, supported by supervisors and managers. The intertwining is created in appealing challenges where students feel safe and ready. In the encounter with the patient they gain a sense of the whole where they can find their personal style. Patients, who feel invited to participate, could describe the encounter with students as genuine and a new dimension in nursing care. These encounters are characterized by closeness, thoroughness, accessibility, acknowledgement and sensitivity. When the encounter is less genuine, supervisors constitute an essential support for stabilizing the care.  Supervisors constantly move in order to either stay close to or stand back, adjusting to the students’ and patients’ needs. Their demanding task as reflective supervisors requires pauses in order to maintain motivation. The managers’ daily struggle in a stressful and challenging reality is influenced by them either having or taking responsibility. Differences in approaches are shown in terms of more or less involvement and commitment in caring environment and educational issues.  Conclusions Genuine encounters are characterized by the core of both caring and learning and will thereby benefit both the students and the patients. Identifying and supporting genuine encounters is necessary for students, supervisors and managers. It is time to find ways to develop a unified view of how caring and learning can be intertwined.

When students learn caring during clinical practice, the usual point of departure is thatcaring and learning coexist, as separate and parallel phenomena. There is, however, a needto study how caring and learning relate to one another, as well as when and how theyconverge. The aim of this dissertation is to describe how caring and learning converge inthe encounters between students and patients, in a dedicated educational unit withinpsychiatric care, as experienced by students, patients, and supervisors. Describing howsupervisory support can facilitate this is another aim. A reflective lifeworld approach basedon phenomenological philosophy has been applied. Data were collected through interviews,participant observations with follow-up interviews, and narrative diaries.The result shows that caring and learning converge in those encounters between studentsand patients which are characterized by reciprocity, wherein the patient’s narrative is thepoint of departure, complemented by the student’s listening and inquiring attitude. It ishere, that the desire for and pursuit of health and understanding, give the reciprocalinteraction power. The common desire of those involved to know, to become accustomedto the new and unfamiliar, as well as the presence of a feeling of responsibility for oneanother, create questions which in turn create opportunities wherein students and patientsare available to one another.The dissertation shows that learning in a caring context can be complex. Despite theirbeing prerequisites for one another, competition and conflicts can occur when the caringand learning perspectives are not equally attended to. When they are placed counter to oneanother, there is a risk that reciprocal interaction is hindered, which can cause loneliness forall involved. For convergence to occur most propitiously, those involved must exist in acaring and learning togetherness. Responsible and present supervisors are needed, whocreate possibilities for the perspectives to converge through maintenance and monitoring, sothat caring and learning receive equal space.A didactic concept has been developed based on the dissertation’s result, focusing on themeaning of creating forums where students’, patients’, and supervisors’ caringconsiderations and reflections can intertwine.

When students learn caring during clinical practice, the usual point of departure is thatcaring and learning coexist, as separate and parallel phenomena. There is, however, a needto study how caring and learning relate to one another, as well as when and how theyconverge. The aim of this dissertation is to describe how caring and learning converge inthe encounters between students and patients, in a dedicated educational unit withinpsychiatric care, as experienced by students, patients, and supervisors. Describing howsupervisory support can facilitate this is another aim. A reflective lifeworld approach basedon phenomenological philosophy has been applied. Data were collected through interviews,participant observations with follow-up interviews, and narrative diaries.The result shows that caring and learning converge in those encounters between studentsand patients which are characterized by reciprocity, wherein the patient’s narrative is thepoint of departure, complemented by the student’s listening and inquiring attitude. It ishere, that the desire for and pursuit of health and understanding, give the reciprocalinteraction power. The common desire of those involved to know, to become accustomedto the new and unfamiliar, as well as the presence of a feeling of responsibility for oneanother, create questions which in turn create opportunities wherein students and patientsare available to one another.The dissertation shows that learning in a caring context can be complex. Despite theirbeing prerequisites for one another, competition and conflicts can occur when the caringand learning perspectives are not equally attended to. When they are placed counter to oneanother, there is a risk that reciprocal interaction is hindered, which can cause loneliness forall involved. For convergence to occur most propitiously, those involved must exist in acaring and learning togetherness. Responsible and present supervisors are needed, whocreate possibilities for the perspectives to converge through maintenance and monitoring, sothat caring and learning receive equal space.A didactic concept has been developed based on the dissertation’s result, focusing on themeaning of creating forums where students’, patients’, and supervisors’ caringconsiderations and reflections can intertwine.

In the 1990s, dedicated education units transformed undergraduate preceptorships, but graduate preceptorships remain static. The dyadic nurse practitioner preceptorship model supports an environment where faculty, students, and preceptors may overlook nuances that affect the teaching-learning process. This article describes an innovative clinical education model, Student and Preceptor Advancement in a Dedicated Education Site, designed to improve preceptorships for advanced practice nurses. The focus is on adaptations made to facilitate use in advanced practice nursing programs.

Bakgrund: Sjuksköterskestudenter kan genomföra verksamhetsförlagd utbildning inom utbildningsvårdavdelningar. En modell benämns Utvecklande och Lärande Vårdenhet (ULVE), där studenter handleds och vårdar i par. Det finns studier som visar att modellen stödjer studenters lärande, men det finns få studier om hur patienter upplever det att vårdas av studenter i par. Därför är det intressant att undersöka hur patienterna ser på att det är två studenter som vårdar dem och hur de upplever den vård de får. Syfte: Syftet med studien är att beskriva patienters erfarenheter av att vårdas av sjuksköterskestudenter som handleds och vårdar i par. Metod: Studien är genomförd med en reflekterande livsvärldsansats grundad i fenomenologisk kunskapsteori. Fenomenet i studien är ”Att vårdas av sjuksköterskestudenter som vårdar och handleds i par”. Data har samlats in via intervjuer av sjutton patienter som vårdats inom ULVE. Resultat: Att vårdas av studenter som handleds i par innebär att bli involverad i studenternas lärande och att mötas av ansvarstagande och en vilja att vårda och lära.  Patienterna känner trygghet och är positivt inställda till att vårdas av studentpar. Tilltro till att vården ges med stöd av handledning bidrar även till trygghet i vårdsituationen. Resultatet beskrivs vidare med innebördselementen: Involverad i lärande och vårdande, Att vara i centrum för vård, Tilltro och tillit till vårdens kvalitet och Att få något utöver det ”vanliga”. Konklusion: Studien visar att patienter som vårdas av studenter som handleds och vårdar i par sätts i centrum, blir tagna på allvar och lyssnade till som människor. Det visar sig i respektfulla möten som präglas av omtänksamhet, engagemang, närvaro och där behov tillgodoses. Studien stödjer att studenter ger god vård när de handleds och vårdar  i par. / Background: Nursing students can complete clinical training in educational hospital wards. A model called Developing and Learning Care Unit (ULVE), where students care and supports in pair. Studies show that the model supports student learning, but there are few studies about how patients perceive to be cared for by students in pairs. It would be of interest to examine what patient’s experience are, what they think about being cared of students who work in pairs and if they believe that they receive good care.  Aim: The aim of this study is to describe how patients’ experience being cared for by student nurses who are caring and supervised in pairs.     Method: The study was conducted with a reflective lifeworld approach based on phenomenological epistemology. The phenomenon of the study is ”to be cared for by  student nurses caring and supports in pairs”. Data was collected through interviews of seventeen patients cared for  within ULVE.       Results: The care of students who are supported in pairs means to become involved in student learning and to meet the responsibility and a desire to nurture and learn. Patients feel secure and are positive to be looked after by student nurses in pair.  Confidence in the healthcare provided under the supervision also contributes to security in the care situation. The result is further described with four meaningful elements: Being involved  in learning and caring, being the center of care,  confidence and trust in the quality of care and  getting something out of the ”ordinary”. Conclusion: The study showed that patients cared by pairs of students is taken seriously and humanly during supervision of nursing clinician and it focuses in a patient centered care. This method of pair nursing students care shows respect, thoughtfulness, engagement and presence to patients where needs are fulfilled.