The aim of this study is to illustrate conditions for the successful implementation of a work model for sustainable care improvement, called Reflecting Team (RT). For this study team leaders were trained in a caring science education programme to lead the reflective processes, and RTs were introduced into two caring contexts. Within the study professional caregivers involved in the implementation of RT were interviewed, and their statements were interpreted according to a life world hermeneutic approach. Dialectic themes emerged that established four prerequisites for successful implementation of RT. A comprehensive understanding suggests that the lowest common denominator for the four prerequisites is mutual interaction. Thus, an atmosphere of sharing was found to be necessary. The challenge of creating such an atmosphere in a caring unit is the focus of the discussion section.

This article illustrates the significance of reflection in nursing and nursing education. In this context reflection is often used as a method that has its roots in Schön's theory of developing knowledge in action through reflection. This approach to reflection is investigated by using the lifeworld theory. Three aspects are used to comprehend the meaning of reflection; the natural attitude, the reflective attitude and the open-minded attitude. These lead us to an understanding that reflection may never be objectified or reduced to a separate process. The article thus strongly refutes the idea that reflection has a technological function in relation to the learning of nursing and caring science knowledge. Describing reflection merely as an educational method or tool is, on this understanding, considered insufficient. A lifeworld perspective allows a new and deeper understanding of the role of reflection in nursing students' learning processes and also in students' abilities to integrate caring science theory with caring practice. This new understanding may have considerable implications for changes in nursing education.

In this article, we present a knowledge approach to the interaction between learning and caring, which should play a significant role in the challenge of promoting sustainable healthcare. This knowledge approach requires awareness of the interactions between learning and caring in caring contexts. The intention is to present an exploration of knowledge and theory development based on research with a lifeworld perspective within caring science didactics. We are illuminating issues concerning reflection and learning encounters in a caring context, which include key concepts such as the patient’s narrative. A strategy for reflective learning and caring based on the lifeworld concept is presented. This strategy includes four main components: the encounter between general knowledge and the patient’s lived world, the patient’s narrative, caring relationship creation through interaction with the patient and reflection through supervision. All of these components are permeated by a reflective approach. We are also clarifying what it means to intertwine learning and caring in addition to how this process can be strengthened in caring practices to optimise patient care. Three components are particularly important in facilitating the intertwining of learning and caring in clinical practice, namely genuine meetings, sensitivity towards the patient’s narrative and reflection during interactions.

Simple surveys are the predominant tool for course evaluations in most universities, but their validity has been questioned. They have been criticized for being a ritual way of complying with administrative regulations rather than a way of improving educational quality. Moreover, there is often a focus on student satisfaction, where the complexity of learning processes and the development of learner identities are lost. As an alternative approach, a qualitative course evaluation was tested that consisted of a single question: What could have been done in this course in order to better support your learning? Twenty-one second-year psychology students completed the evaluation at the end of a course. They provided rich answers describing learning activities and communication, and they described both teachers and students as agents. Going beyond merely reporting possible improvements, the students saw their learning processes in a context of academic demands and social mechanisms. It is argued that qualitative course evaluations can provide information about students’ understanding of their own learning that is difficult to uncover in a traditional survey. It is concluded that qualitative course evaluations would support the development of a student learner identity and help create a role for students as co-producers of knowledge.

There are two sides to the concept of ambivalence. One concerns contradictory attitudes, expressions or feelings that are simultaneously directed toward an object, person or action, the other concerns undecidability and a fluctuation of meaning between a thing and its opposite. Both of them concern an aspect of uncertainty. In this article we argue that reflection and reflection projects are caught up within ambiguity between two discourses on human thinking and action: one which conceives humans as rational intellectual beings who elaborate practical actions by following certain procedures and one where human practice is changeable, complex and follows its own logic (or rather un-logic). These discourses have different genealogies and social agendas. However, they also meet, not only in different reflection projects in education but also in classical reflection texts. The example we are going to use to illustrate this is Schon's The reflective practitioner. We claim that the discursive struggle over reflection makes the theoretical basis for the reflection projects confusing and even fragile, as well as potentially dynamic, creative and productive.

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. © 2015 Taylor & Francis.

Our general purpose is to show how a philosophically oriented theoretical foundation, drawn from a lifeworld perspective can serve as a coherent direction for caring practices in education. We argue that both caring and learning share the same ontological foundation and point to this intertwining from a philosophical perspective. We proceed by illustrating shared epistemological ground through some novel educational practices in the professional preparation of carers. Beginning in a phenomenologically oriented philosophical foundation, we will first unfold what this means in the practice of caring, and secondly what it means for education and learning to care in humanly sensitive ways. We then share some ways that may be valuable in supporting learning and health that provides a basis for an existential understanding. We argue that existential understanding may offer a way to bridge the categorisations in contemporary health care that flow from problematic dualisms such as mind and body, illness and well-being, theory and practice, caring and learning. Ways of overcoming such dualistic splits and new existential understandings are needed to pave the way for a care that is up to the task of responding to both human possibilities and vulnerabilities, within the complexity of existence. As such, we argue that caring and learning are to be understood as an intertwined phenomenon of pivotal importance in education of both sensible and sensitive carers. Lifeworld led didactics and reflection, which are seen as the core of learning, constitute an important educational strategy here.

To meet the Swedish healthcare legislation’s requirements for evidence-based care, a work model for reflection has been developed, called a reflective team (RT). Because this RT model can be perceived as either a competitor of or a complement to caring supervision, this case study aims to explore what distinguishes these two in psychiatric care. Five members of one RT who are psychiatric nurses with previous experiences in caring supervision were interviewed. The transcribed interviews were analysed according to phenomenography. The findings reveal three qualitatively separated categories, which describe differences in focus, competencies, and relationships between confirmation and demands. It is concluded that an RT by no means replaces supervision. Instead, both can contribute to care improvement by complementing each other and increasing the professionalism of psychiatric nurses

A reflective team (RT) is a team of professional carers who reflect on a specific caring issue under the direction of an RT leader. The goal for the reflective process is to accomplish care improvement based on research and proven experience, and the first step is to reflect upon the competence that already exists in the context where RT takes place. This study aims to bring previous unarticulated competence for dementia care to the surface, after it has been reflected during RT sessions. Ten staff nurses who work close to patients with dementia and attend RT sessions on regular basis were interviewed about their competence for dementia care. Through a phenomenographic analyze two qualitatively separated categories emerged; general caring skills and specific dementia caring skills. It is concluded that specific skills for dementia care build on general caring skills, and that tacit knowledge can emerge to proven experience when it has been reflected in RT.

This qualitative study aims to describe nursing students' experiences of learning caring science by using reflection seminars as a didactic model. A reflective lifeworld research approach according to Husserl's phenomenological philosophy was used. Findings suggest that reflective seminars increased understanding of caring science, other people and one's self. Moreover, substance-oriented reflection and lifeworld perspectives provided a good learning environment. Learning prerequisites were found to be openness, honesty, respect, trust, security, justice, parity and shared responsibilities along with having a common platform and a clear framework. These findings highlight conditions for a culture conducive to learning and for gaining embodied knowledge, but also present concerns regarding the difficulty and importance of establishing a good learning environment. A need to create meaningfulness, establish caring as conscious, reflective acts and show the value in personal differences were also found. These findings offer an important perspective necessary for preparing nurses to perform good quality care.

This paper presents a research study that aims to describe and analyse how caring assessment is learnt in the Specialist Nursing, Prehospital Care Programme for educating specialist ambulance nurses. The study is based on a contextual and didactic model for learning. The focus was on the final course, Prehospital Emergency Care, with clinical studies and clinical practice amounting to 15 credits, plus one of two theoretical examinations. We are testing the model to explore what characterises the students’ learning when the model is applied. The informants were 37 students (registered nurses). Written data from all 37 examinations were analysed by means of the phenomenological Reflective lifeworld research approach. The results stress the significance of a didactic model constructed according to the specific circumstances prevailing in the learning context. With the help of the model an attitude of reflective awareness is adopted, showing that knowledge in caring science and medical science are equally valuable and, are applied simultaneously. Furthermore, the model generates knowledge that underlines the significance of the encounter with the patient in the care-giving context of the prehospital environment, in order for the student to be able to develop understanding and to learn caring assessment in prehospital emergency care. Thus the result reveals that it is the encounter with the patient that is most effective for the student’s learning process. Keywords: didactic model; reflections; reflective awareness; specialist ambulance nurses; nursing training