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Vårdande och lärande sammanflätas i genuina möten: erfarenheter, förutsättningar och ansvar på utbildningsvårdavdelning
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0003-4881-572X
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

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. 

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2016. , 77 p.
Series
Linnaeus University Dissertations, 241/2016
Keyword [en]
Caring, learning, reflective lifeworld research, genuine encounter, dedicated education unit, phenomenology. lifeworld-led didactics
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-49776Libris ID: 19283829ISBN: 978-91-87925-99-3 (print)OAI: oai:DiVA.org:lnu-49776DiVA: diva2:903427
Public defence
2016-03-04, Sparbankssalen, Högskolan i Borås, Allégatan 1, Borås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2016-02-17 Created: 2016-02-15 Last updated: 2016-11-18Bibliographically approved
List of papers
1. Student nurses’ experiences of how caring andlearning is intertwined: A phenomenological study
Open this publication in new window or tab >>Student nurses’ experiences of how caring andlearning is intertwined: A phenomenological study
2014 (English)In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 4, no 2, 82-93 p.Article in journal (Refereed) Published
Abstract [en]

Background: Clinical studies in nursing education ought to create conditions for the students to link theory to praxis.Previous research in this field focuses on the gap between theory and practice, learning environments, supervision andreflection connected to caring and learning. In addition there are studies that propose the concept of learning and caring asintertwined. The aim of this study is to describe how caring and learning is intertwined from a student perspective.Methods: The study was carried out using Reflective Lifeworld Research (RLR) with a phenomenological approach.Lifeworld interviews were conducted with students after their clinical placement on a Dedicated Education Unit (DEU).Results: The essential meaning is a movement where caring and learning fall into place which appears in an atmospherefilled with appealing challenges, but has to be sensitive to the students’ readiness. The atmosphere depends on their senseof security and how they experience confirming and affirming responses. Encountering the patient means that the studentscan gain a sense of the whole and the theory falls into place. The results also highlight how the student, in this atmosphere,has a desire to find a new role in a personal style.Conclusions: The study emphasizes the importance of supporting the students in understanding learning and caring asintertwined and not separated. A dualistic approach could harm the students’ aim to get the knowledge embodied. Thisholistic perspective requires a reflective attitude on caring and learning and has to be further developed in the didactics andsupervision.

Place, publisher, year, edition, pages
Sciedu Press, 2014
Keyword
Caring, Learning, Student nurse, Experience, Dedicated education unit, Lifeworld, Didactic, Phenomenological
National Category
Other Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-29614 (URN)10.5430/jnep.v4n2p82 (DOI)
Available from: 2013-10-16 Created: 2013-10-16 Last updated: 2017-12-06Bibliographically approved
2. The experiences of patients receiving care from nursing students at a Dedicated Education Unit: A phenomenological study
Open this publication in new window or tab >>The experiences of patients receiving care from nursing students at a Dedicated Education Unit: A phenomenological study
2015 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 15, no 5, 353-358 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study is to describe how patients perceive being cared for by student nurses, in a clinical context in the form of a Dedicated Education Unit (DEU). The study has been performed with a Reflective Lifeworld Research (RLR) approach grounded in phenomenology. Lifeworld interviews were conducted with patients who had received care from student nurses on an orthopaedic dedicated education unit (DEU) and data have been analysed for meanings. The findings reveal how patients experience to be carried along as a part of the students' learning process. This is described in more detail via the constituents: a mutual invitation to participe, the importance of genuine encounters, and essential support. Patients experience both a stable and a less stable care in a learning environment and it is thus essential for them to be invited to be a part of both the students’ learning process and their own health process. The findings also highlight the key role of the supervisors for patients’ sense of security. Finally there are indications that concepts such as DEU with a lifeworld-led didactic, based on reflection on both the patients’ stories and the students’ experiences, can create learning environments that support patients’ health processes and also students’ learning processes.

Place, publisher, year, edition, pages
Elsevier, 2015
Keyword
Patient, caring, learning, Dedicated education unit (DEU), Lifeworld
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-42673 (URN)10.1016/j.nepr.2015.04.001 (DOI)000361868300004 ()25913170 (PubMedID)2-s2.0-84941809749 (Scopus ID)
Available from: 2015-04-16 Created: 2015-04-16 Last updated: 2017-12-04Bibliographically approved
3. Caring and learning intertwined in supervision at a dedicated education unit: a phenomenological study
Open this publication in new window or tab >>Caring and learning intertwined in supervision at a dedicated education unit: a phenomenological study
Show others...
2015 (English)In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 16, no 6, 753-764 p.Article in journal (Refereed) Published
Abstract [en]

Supervising student nurses in clinical praxis entails dealing with both caring and learning aspects. There is a dearth of research focusing on both the caring and learning aspects in supervision. The present study describes how caring and learning is intertwined in supervision. The study was performed with a Reflective Lifeworld Research approach and analyzed phenomenologically for meanings. Eight interviews were conducted with supervisors on an orthopedic-dedicated education unit. The findings reveal how supervisors constantly move in order to be either close to or standing back, adjusting to the students’ and the patients’ needs. This is described in more detail via the constituents: handling responsibility in constant movement, participating in a new and different way, coexisting with students creates meaning and development. The findings show that a reflective attitude in supervision, clear structure for daily activities, and a lifeworld-led didactics can promote a learning and caring environment. Supervisors’ demanding task requires pauses in order to maintain motivation among supervisors. A mutual link between supervisors, students and patients is crucial in order to create an environment where caring and learning are intertwined.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keyword
supervisor, caring, dedicated education unit, lifeworld, phenomenology
National Category
Didactics Nursing Pedagogy
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-47609 (URN)10.1080/14623943.2015.1095726 (DOI)000365611200004 ()2-s2.0-84948580554 (Scopus ID)
Available from: 2015-11-26 Created: 2015-11-26 Last updated: 2017-12-01Bibliographically approved

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