Nurse Education in Practice 11 (2011) 384e389

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Nurse Education in Practice

journal homepage: www.elsevier.com/nepr

A learning model for nursing students during clinical studiesq

Margaretha Ekebergh*
Borås University, School of Health Sciences, SE-501 90, Borås, Sweden

a r t i c l e i n f o a b s t r a c t

Article history: This paper presents a research project where the aim was to develop a new model for learning support in
Accepted 20 March 2011 nursing education that makes it possible for the student to encounter both the theoretical caring science
structure and the patient’s lived experiences in his/her learning process.
Keywords: A reflective group supervision model was developed and tested. The supervision was lead by a teacher
Nursing training and a nurse and started in patient narratives that the students brought to the supervision sessions. The
Supervision
narratives were analyzed by using caring science concepts with the purpose of creating a unity of theory
Reflection
and lived experiences.
Theory/practice
Lifeworld theory
Data has been collected and analyzed phenomenologically in order to develop knowledge of the
students’ reflection and learning when using the supervision model.
The result shows that the students have had good use of the theoretical concepts in creating a deeper
understanding for the patient. They have learned to reflect more systematically and the learning situ-
ation has become more realistic to them as it is now carried out in a patient near context. In order to
reach these results, however, demands the necessity of recognizing the students’ lifeworld in the
supervision process.
Ó 2011 Elsevier Ltd. All rights reserved.

Introduction
The challenge in nursing education is to create fruitful condi-
tions for a learning encounter between the student’s own lifeworld
and knowledge in theory and practice. Learning strategies are
needed in order to support a reflective process that strengthens the
interweaving of the lifeworld and theoretical and practical
knowledge. This paper presents a project, where the purpose was
to develop a learning model in the form of a supervision model,
which is able to meet these demands.
Background
Students in the undergraduate Nursing programme gain
professional knowledge that is based on caring science the pro-
gramme’s major subject. Caring science is the academic discipline
that develops knowledge about the patient’s world, which means
a holistic perspective about the meaning of illness. This knowledge
q This paper was presented at the NETNEP 2010 3rd International Nurse
Education Conference - Nursing Education in a Global Community: collaboration
and networking for the future, 11e14th April 2010, Sydney, Australia.
* Tel.: þ46 732 30 59 49.
E-mail address: margaretha.ekebergh@hb.se.
is the foundation for nursing. The caring sciences exist in both
theory and in practice, which means that there are two fields of
knowledge from which knowledge about caring can be acquired. In
the theoretical field of caring science we work with abstract and
general descriptions of caring, which are not the same as the often
more complex reality of practical caring. Students assimilate the
theoretical meanings of the major terms in caring science but have
difficulty in converting them or using them as tools when
encountering patients in clinical practice. In order to find a solution
for this problematical situation in the nursing students’ learning
process, a learning strategy is needed so that the abstract caring
science knowledge can encounter the lived reality of the practical
field so that the students can acquire caring science knowledge that
is optimal for use in a caring context.
There are a comprehensive number of studies within the field of
teaching and learning in nursing education. With a focus on the
theoryepractice relationship and reflection, some themes appear in
a selection of studies. One theme is reflection as a support for learning,
which includes studies such as, Williams (2000), Welch et al. (2001),
Ekebergh et al. (2004), O’Callaghan (2005), Tveiten and Severinsson
(2006), Avis and Freshwater (2006) and Crowe and O’Malley (2006).
Another theme is collaboration between academia and clinical prac-
tice and here there are studies such as Davies et al. (1999), Perry
(2000), Mayer (2000). A further theme is, linking theory with prac-
tical caring, which includes research publications such as; Mitchell

1471-5953/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.nepr.2011.03.018
 M. Ekebergh / Nurse Education in Practice 11 (2011) 384e389
(2002), Milton (2003), Gallagher (2003), Letcher and Yancey (2004)
and Van’t Hooft (2005). Finally there is one theme, models for
supervision and learning and here we find among others Häggman-
Laitila et al. (2007) and Spector-Levy et al. (2008).
Several of these studies show the complexity in the relationship
between theory and practice and call for more research to find the
core of learning in a professional training such as nursing educa-
tion. An obvious lack in previous research is that very little atten-
tion has been given to the student’s lifeworld in the learning
process, and also the importance of the substance of learning and
its scientific base for developing learning support. The present
project thus takes its starting point in lifeworld and reflection in
connection with theory and practice of caring science to combine
all these aspects in developing a learning model.
The follow questions were addressed in the project:
 Which learning strategy can, in a fruitful way, support the
interweaving of theory and practice with the student’s
lifeworld?
 How can we apply reflection to link theory with practice?
 How can the supervisor meet the student’s lifeworld?
 How should theory be applied to meet the experience-based
knowledge in practice?
Theoretical foundation for the project
The idea of the project is grounded in a lifeworld approach,
which emphasizes the learner’s learning attitude, experiences and
embodied understanding. The platform for learning and reflection
is the lifeworld. The latter, according to Husserl’s (1973) philosophy,
relates to the natural attitude, which involves a type of approach to
our everyday activities (Dahlberg et al., 2008). The natural attitude
characterizes activity in which humans are completely directed
towards, immersed in, and absorbed by the activity, or the being, of
the moment. In everyday activities humans do not consciously
analyze what they are experiencing, but presuppose what they are
absorbed in as existing in the way they perceived it. Consequently
a person’s natural attitude is basically unreflective. All meaning has
its origin in the lifeworld and it is the prerequisite for all cultivation
of knowledge. The lifeworld can, according to Husserl (1970, 1998)
be examined and conceptualized through reflection and in that way
be brought to awareness and be articulated. It is thus through
reflection the learning process starts and is continuously ongoing in
the development of individual understanding.
The idea of lifeworld is also a foundation for caring and nursing.
It is through a lifeworld perspective that it is possible to understand
the patient’s situation and to be able to relieve suffering and
support wellbeing. Caring and learning support have a common
challenge, which is to be open and sensitive to the patient’s life-
world in the caring situation and to the student’s lifeworld in the
learning situation. This aspect is of crucial importance to be aware
of in the clinical learning process.
Implementation of a supervision model
The project has had an intervention approach and was carried
out during two years in the undergraduate nursing program. The
implementation has followed the underpinning ideas of the life-
world perspective, which had previously been applied by Ekebergh
et al. (2004). Four principles form the foundation for the develop-
ment of the model.
 integration of caring science in theory with practical nursing
experiences is achieved by conscious and systematic reflection.
385
 caring science in theory comes alive through patients’ narra-
tives that are based on lived experiences.
 the starting point for reflection and learning is in the student’s
lifeworld.
 reflection can be further stimulated by drama activities.
From this foundation a supervision model was developed for
reflective learning, based in caring science and built around the
following components:
 Student-groups with 6 students in each group were formed for
caring science reflective learning in the practical nursing field,
in hospital and community care, and during a 10-week clinical
studies period in the undergraduate programme in nursing.
 The groups were lead by a teacher (¼ theoretical caring science
perspective) and a nurse (¼ practical caring science perspec-
tive). They were trained in a specialized 5-week course. The
course consisted of a theoretical part, followed by a practical
one, where the participants were able to practice reflective
supervision based in caring science and also become familiar
with working in pairs in the supervision session
 The groups gathered every second week.
 The students brought written narratives with them to the
reflection group and these narratives constituted the basis for
the reflective work.
 The reflective work was carried out with the help of caring
science concepts and theory and with elements of creative
didactics in the form of drama activities.
The characteristic of this model is the ontological and episte-
mological foundation in lifeworld perspective and caring science,
which gives a new understanding in supporting learning in prac-
tice. This special idea has not been focused in earlier research.
Aim
The aim of this study is to develop knowledge about the inter-
weaving of the lifeworld and theoretical and practical knowledge in
the student’s learning process. More precisely it is to describe how
this interweaving can be realized with help of a caring science
reflective supervision model, during clinical studies.
Method
The methodological approach is based on phenomenological
epistemology as described by Dahlberg et al. (2008) and developed
as a reflective lifeworld research (RLR) approach. The RLR is built on
an interest in the lifeworld, which forms the foundation of under-
standing humans, our lives and our developing and learning. In this
approach, researching openness is emphasized in terms of the
“bridling” of the researcher’s emerging understanding of the studied
phenomenon, which in this study is; the interweaving of the lifeworld
and theoretical and practical knowledge, with help from a caring
science reflective supervision model, as it is perceived by students and
supervisors. The RLR approach thus opens up a research attitude to
the world as it presents itself; it maintains a sensitivity to the
ambiguity of the lifeworld (Dahlberg and Dahlberg, 2003). To
“bridle” the process of understanding does not mean a belief of
setting aside all pre-understanding, which is impossible, Pre-
understanding is necessary condition for understanding, but if it is
left “uncontrolled” it makes us see what we expect to see and have
always seen. The idea of bridling demands from researchers
a reflective and critical attitude in which one “slows down” the
process of understanding in order to see the studied phenomenon in
386 M. Ekebergh / Nurse Education in Practice 11 (2011) 384e389
Table 1
Data collection.
Student Supervisor
interviews interviews
Group interviews 25 (5e6 in each 4:
group) 2 with teachers (4 in each
group),
2 with nurses (4 in each
group)
Individual 8 4:
interviews 2 with teachers, 2 with
nurses
a new way. In the present study the aim has been to maintain this
research attitude throughout the research process.
Data
Data has continuously been collected during the two years of
the project and consists of group interviews and individual inter-
views with students and supervisors, according to Table 1.
Students and supervisors were asked to participate in group
interviews at the end of a clinical training period. All the students
and supervisors who were involved in the supervision groups gave
their permission to participate. The group interviews were carried
out in the clinical setting on the last day of students’ training
period.
The informants in the individual interviews were selected from
the group interviews with the purpose of getting a deeper meaning
of the present phenomenon; the interweaving of the lifeworld and
theoretical and practical knowledge with help from a caring science
reflective supervision model. The individual interviews were carried
out at the university two weeks after the group interviews.
The interviews have been carried out with a lifeworld approach
(Dahlberg et al., 2008). The interviews thus focused on experi-
ences of the supervision model’s importance for the interweaving
of theory and practice, which also includes the understanding the
patient’s world. The initial question was; “How was the supervi-
sion”, which was followed up in a conversation with the aim of
capturing the students’ learning and reflection, i.e. how they think
and feel regarding their understanding of the patient’s situation
and needs. Furthermore, their expressions of what they have
learnt and how they thought about their personal growth was also
of importance.
The interviews with the teachers and nurses, i.e. the supervisors,
started with the question; How is it to supervise according to the
principles of this model, which was followed up in a conversation
centred on their experiences of using the supervision model for
interweaving caring science theory with practice. Their views on
meeting the students in their lifeworld and creating a learning and
reflective atmosphere were also important.
Data analyses
All interviews were tape recorded and transcribed verbatim. The
analysis followed the guidelines of the RLR approach (Dahlberg
et al., 2008). The transcribed interviews were analysed for
meaning, with the aim to describe a general structure of meanings
that constitute and characterized the phenomenon in focus. The
analysis was carried out with open “bridled” interrogative
methods. The work, which is characterized as both an analysis and
a synthesis, can be seem as a dynamic approach to data in which
one meaning temporarily is understood as a figure against the rest
of the material as background. The next moment another meaning
is a figure, and the meaning that recently was a figure is now part of
the background. With this method a structure of the meaning of the
phenomenon could be described.
The structure of meaning can be generalized in relation to other
contexts than the research context, and the result in this study can
thus be used in other educational settings. However all meanings
are understood as contextual and all generalizations must pay
attention to contextual aspects (Dahlberg et al., 2008). The analysis
procedure also includes descriptions of the various meanings that
constitute the phenomenon, which are the variations and the
nuances of the phenomenon, which are more contextual then the
general structure. In this paper, however, it is only the essential
meanings i.e. the general structure of the findings that is presented.
The latter is on an abstract level, without concrete descriptions. In
the discussion of the results some quotations that illustrate the
findings will be presented.
The interviews of the students and the supervisors were ana-
lysed separately and the two analyses have resulted in two essential
meaning structures.
Ethical considerations
This study, conducted in 2006, conformed to the principles
outlined in the Declaration of Helsinki (World Medical Association
Declaration, 2005) and the Swedish National Board of Health and
Welfare (2003). Permission was given from the management of
the University. The informants gave both oral and written
permission for their participation in the study.
Results
The students’ perspective
The general structure, of the interweaving of the lifeworld and
theoretical and practical knowledge with help from a caring science
reflective supervision model, from the students’ perspective, shows
that the supervision, as a learning support, entails symbolically
a confrontation between the student’s lifeworld, the caring science
and the patient’s lived world. A vital learning process begins with
this confrontation, which engages and creates tension in the
student’s world. Prejudices are challenged and the power of curi-
osity constitutes the basis for discovering the patient’s world. The
students are forced to step out from their natural attitude, i.e. their
presumptions, and with reflection “see the patient”. This is stimu-
lated with the help of the caring science concepts, which open
horizons for new understanding of the patient and his/her needs.
The starting point for learning is the encounter with the patient
and his/her suffering. Receiving the patient’s narrative is, according
to the students’, a reverent act. They show great respect for it as
conversations with patients can create insecurity and fear. If the
students do not get support in mastering this encounter with the
patients, they will instead withdraw from the close proximity to
the patient and observe the caring event from a distance.
The reflection and analysis of the patient’s narrative, with the
help of caring science concepts, constitute a vital movement in the
learning process between the entirety and its parts. The challenge
for the students is to see the entirety in relation to its parts and the
parts in relation to its entirety. A new understanding might occur
that gradually settles in the body as an embodied understanding. If
the movement fails to appear the learning might become frag-
mental and shallow.
It is obvious, according to the findings from the students’
interviews, that a good learning support requires an open approach
to the students’ lifeworld. The students’ need for learning is
expected to have priority in the supervision, and the prerequisite
for that is the interaction between the patient’s lifeworld, which is
 M. Ekebergh / Nurse Education in Practice 11 (2011) 384e389
in focus in the supervision session, and the student’s lifeworld. The
group plays an important role in creating the space for each
student’s learning and personal growth.
The supervisors’ perspective
The general structure, of the interweaving of the lifeworld and
theoretical and practical knowledge with help from a caring science
reflective supervision model, from supervisors’ perspective, show
that the learning strength in supervision is created when “two
worlds” meet in an attuned unity. This forms a solid basis for
combining theory and practice. The supervision unity is charac-
terized by mutuality and respect of each other’s knowledge. This
unity is, however, vulnerable and requires proximity and openness
for the two worlds in order to create a safe co-operation. The co-
operation requires courage in order to present and represent the
knowledge each supervisor has for providing role models for the
students, who gain a greater understanding of these role models
through the reflection.
Reflection in the supervision takes place at the same time in
both supervisors and students and finds nourishment in feelings
that are discovered and articulated. The purpose of reflection is to
confuse, disarrange and thereby awaken itself. By visualizing ways
for thoughts and reflection, patterns of thinking become clear to
the students and they can thereby experience the possibilities of
reflection.
The challenge for the supervision is to meet the student in her/
his learning. It is essential that the supervisors listen, see and feel in
order to notice the student’s needs for support. It is a matter of
a genuine interest with an emotional commitment for the student
and her/his learning. The goal is to have an open and flexible atti-
tude, with balance as a motto; a balance between being flexible and
challenging, and between being demanding and permitting.
The aim of the supervision is to create a learning and joyful
environment where students become interested in learning more.
The scientific terminology is woven into the patient’s narrative
which is the foundation for the learning environment. The purpose
is for the student to attain a greater understanding of the patient’s
situation by methodically working with caring science knowledge,
the patient’s narrative and practical knowledge. The overriding
obstacle for the student’s learning process can be traced back to
both students and supervisors. The major obstacles, however, are
related to difficulties for supervisors in approaching the student’s
learning profile, problems with clarifying the patient perspective in
relation to care and a lack of competence in caring science.
Discussion
The findings show among others that there are some necessary
prerequisites for positive outcomes of the supervision model,
which can be summarized as acknowledging the student’s lifeworld
in the supervision.
There is extensive research regarding reflection and learning as
well as on integration of theory with practice in health care (see the
background). But the present project shows findings that have not
before been highlighted in this way.
Balancing the student’s lifeworld with the patient’s
The challenge for the supervisors is to maintain a clear patient
perspective in the supervision so that the students can understand
and acquire that perspective, but at the same time the supervisors
must be open to the students’ lifeworld. A rivalry may occur
between two lifeworld foci; the patients and the students (cf.
Ekebergh et al., 2004). The students may need to share experiences
387
that affect them on a personal level, i.e. their own thoughts and
feelings that they associate with the narrative at hand. One student
expressed this as, It is sometimes too much focus on one patient’s
narrative and if I want to discuss something similar, that I have
thought of, then I am not allowed to do that, it is very frustrating and I
feel then not accepted in the group. Another student said, I need to
discuss my thoughts and feelings that occur in the clinical setting and
sometimes I have so many questions that I do not get any answer on. If
the supervisors do not create a space for this, but hold on to the
patient narrative, students can experience insecurity which leads to
disappointment and criticism of the supervision. The ideal super-
vision is flexible and follows the students’ needs to learn about the
patient’s world, as one supervisor expressed, you must be very
sensitive to the students’ expectations and to their needs of support
and it can be very hard to find the balance between this and the work
with the patient ‘s narrative. Good supervision takes its starting
point in the student and remains in the student’s experiences and
feelings, and from this moves to clarify the interplay with the
patient’s lifeworld. The challenge is therefore for the supervisor to
create a space for every student’s lifeworld and use, what van
Manen (1993) terms as a pedagogical tact, which can be under-
stood as a sensitive approach to support learning.
Caring science concepts- a forced structure
The importance of using caring science concepts as tools for
understanding caring phenomena has been studied and described
by Mitchell (2002) and Letcher and Yancey (2004). The findings in
the present study show however that this strategy might become
limiting in the supervision. This occurs when the concepts
constitute a method that divides the narrative and the meaning-
seeking aspect is lost, which this quote from a student shows, To
relate to certain concepts the whole time, was really exaggerated and
very complicated. It was a bit artificial to put everything under
different concepts and you almost analysed the narrative into small
pieces without making any progress in this situation. I can not see the
point in put everything in appropriate caring science concepts, I think
it is better to have a bigger view. The terminology becomes the
focus when they are added to the narrative; which concept fits to
the narrative in question. The narrative is broken up with the help
of the terminology, something the students experience as chop-
ping up the narrative and they cannot recognize the narrative as it
was from the start. If there is no problematisation of the contents,
and no entirety is recreated in order to form an understanding of
the patient’s narrative in a deeper and wider manner, the caring
concepts loose their meaning in the learning process. Too much
focus on terminology in the supervision can result in a vague and
shallow learning, instead of a greater and more integrated
understanding. According to Mcalpine and Weston (2000) it is
significant for the reflection to reflect towards a knowledge that is
more than just experience. Accordingly the supervisors have an
important task in being flexible towards the students’ process of
understanding and create a movement between the entirety of the
patient narrative and its parts and maintain this movement with
help of caring concepts, which can enable a meaningful under-
standing. That this is possible appears in a quote from a super-
visor; the concepts are there in a natural way in the narratives and it
is quite visible how the theoretical knowledge can be linked to the
caring reality.
The reflection is the “hub” in the supervision. There are different
reflection models, for example Gibbs’s reflective cycle (1988),
Mezirow’s levels of reflectivity (1991) and Johns’ model (1999,
2002), with the intention of facilitating the learner’s reflection
process. According to the findings in the present project it might be
risky to use reflection models, at least to slavishly follow them step
388 M. Ekebergh / Nurse Education in Practice 11 (2011) 384e389
by step, because reflection can never be reduced to different stages,
reflection must be supported in an open, flexible and sensitive way
in relation to the learner. If a model or method directs the super-
vision and learning process in a dominant way, without any
attention being paid to the learner’s lifeworld, then it will have no
benefit for the learning. This was also obvious when the supervisors
used the caring science concepts as a dominant structure. Previous
research has shown how frail a teaching procedure becomes, when
adhering to a method step by step (Ekebergh et al., 2004). This
aspect of using reflection models has, however, been given very
little consideration in the literature about reflective practice or
guided reflection.
Execution of the project
Carrying out a development project is, of course, associated
with difficulties. The most prominent strengths such as, openness
and flexibility, have also caused difficulties. To work flexibly entails
being very sensitive to the needs for information about the
involved participants. There were at times weak points in the
anchoring of the project’s basic ideas among both students and
supervisors. The importance of close and strong collaboration
between the academia and practice has been the emphasis in
several projects (Mayer, 2000; Häggman-Laitila, et al., 2007). This
has been a central part in the present project as both teachers and
nurses have carried out supervision, a quote from a nurse super-
visor is; in the beginning it was hard to collaborate, we were coming
from different worlds, and it took time for us to get to know each
other and how we should work together in the supervision with the
students. The course that we took really helped us to be integrative. In
addition there is little experience of educational development in
the field of care which is why this type of work is unfamiliar to
some caregivers and for others it is less important in the care
context. Davies, et al., 1999 show however how this kind of project
can develop and strengthen the health care staff’s ability to work
in research and development projects.
The collaboration and information to hospitals and community
care were of crucial importance, as the supervision model was to
be applied in the clinical practice, during the students’ clinical
studies. Contacts were established with key-persons in theses
contexts. Information programmes were carried out in the prac-
tical field. The implementation of this work was systematic and
well-planned.
Reflection on the methodological procedure
The research approach used in this study enabled us to reach the
students’ and supervisors’ lifeworlds i.e. their experiences of the
studied phenomenon. The motive to use group interviews was
related to the idea in the project, to reflect in groups, which starts
a reflection process that stimulates each person in the group to
come further in the reflection, which is important in order to get
rich data in an interview. There are, however, some limitations in
group interviews, as it is not possible to reach the lifeworld in
a deeper sense. It was thus important to carry out some individual
interviews in addition to the group data. The criteria for the indi-
vidual interviews were informants who had displayed a developed
reflective attitude in the group interviews and therefore had
something more to contribute with on essential issues. In the
analyse process it was obvious that the individual interviews
contribute with meanings that were not found in the group inter-
views. There was a generally very positive attitude among the
students and supervisor to participate in the interviews and it was
thus no problem in obtaining a large data material, which was
helpful for the analysis process.
Conclusions
The present project’s contribution to the knowledge about
learning in practice is mainly:
 If a supervision model is to become successful, it has to take its
starting point in the student’s lifeworld.
 In order to create an interweaving of theory and practice, the
reflection should start in the patient’s narrative and be the core
of the supervision situation.
 The support for the interweaving is best generated by a teacher
and a nurse co-operating in the supervision group.
 The common ontological and epistemological foundations in
lifeworld, for caring and learning support, becomes visible in
this supervision model, which helps the student to understand
the patient perspective in the nursing field.
Further research is needed about learning in nursing educa-
tion in clinical studies. Based on the outcomes of this project
research questions could be phrased as follows: how can
a learning environment be created with the potential to support
the interweaving process in the bed side area in clinical settings?
How can the supervision idea in this project be applied in
bedside supervision? How can it be applied in other learning
contexts.
References
Avis, M., Freshwater, D., 2006. Evidence for practice, epistemology, and critical
reflection. Nursing Philosophy 7 (4), 216e224.
Crowe, M., O’Malley, J., 2006. Teaching critical reflection skills for advanced mental
health nursing practice: a deconstructive-reconstructive approach. Journal of
Advanced Nursing 56 (1), 79e87.
Dahlberg, K., Dahlberg, H., 2003. To not make definite what is indefinite.
a phenomenological analysis of perception and its epistemological conse-
quences. Journal of the Humanistic Psychologist 31 (4), 34e50.
Dahlberg, H., Dahlberg, K., Nyström, M., 2008. Reflective Lifeworld Research. Stu-
dentlitteratur, Lund.
Davies, C., Welham, V., Glover, A., Jones, L., Murphy, F., 1999. Teaching in practice.
Nursing Standard 13 (35), 33e38.
Ekebergh, M., Lepp, M., Dahlberg, K., 2004. Reflective learning with drama in
nursing education - a Swedish attempt to overcome the theory praxis gap.
Nurse Education Today 24, 622e628.
Gallagher, P., 2003. Re-thinking the theory-practice relationship in nursing: an
alternative perspective. Contemporary Nurse 14 (2), 205e210.
Gibbs, G., 1988. Learning by Doing: A Guide to Teaching and Learning Methods.
Further Education Unit. Oxford Polytechnic, now Oxford Brookes University.
Häggman-Laitila, A., Elina, E., Riitta, M., Kirsi, S., Leena, R., 2007. Nursing students in
clinical practice e developing a model for clinical supervision. Nurse Education
in Practice 7 (6), 462e477.
Husserl, E., 1970. Logical Investigations. Volume 1 Prolegomena to Pure Logic. Expres-
sion and Meaning. The Ideal Unity of the Species. Routledge & Kegan Paul, London.
Husserl, E., 1973. Experience and Judgment. North Western University Press,
Evanston IL.
Husserl, E., 1998. Ideas Pertaining to a Pure Phenomenology and a Phenomenolog-
ical Philosophy (F. Kersten, Trans.). Kluwer Academic Publ., Dordrecht.
Johns, C., 1999. Becoming a Reflective Practitioner. Blackwell Science Ltd, Oxford.
Johns, C., 2002. Guided Reflection. Advancing Practice. Blackwell Science Ltd,
Oxford.
Letcher, D.C., Yancey, N.R., 2004. Witnessing change with aspiring nurses: a human
becoming teaching-learning process in nursing education. Nursing Science
Quarterly 17 (1), 36e41.
Mayer, D.M., 2000. Academia and practice: working together to provide continuing
education. Dimension of Critical Care Nursing 19 (6), 26e29.
Mcalpine, L., Weston, C., 2000. Reflection: issues related to improving professors’
teaching and students’ learning. Instructional Science 28, 363e385.
Mezirow, J., 1991. Transformative Dimensions of Adult Learning. Jossey-Bass
Publishers, San Francisco.
Milton, C.L., 2003. A graduate curriculum guided by human becoming: journey with
the possible. Nursing Science Quarterly 16 (3), 214e218.
Mitchell, G.J., 2002. Learning to practice the discipline of nursing. Nursing Science
Quarterly 15 (3), 209e213.
O’Callaghan, N., 2005. The use of expert practice to explore reflection. Nursing
Standard 19 (39), 41e47.
Perry, I., 2000. Buildning bridges to clinical practice. Kaitiaki Nursing New Zealand
6 (1), 18e20.
 M. Ekebergh / Nurse Education in Practice 11 (2011) 384e389
Spector-Levy, O., Bat-sheva, E., Zahava, S., 2008. Teaching communication skills in
science: tracing teacher change. teaching and teacher education. An Interna-
tional Journal of Research and Studies 24 (2), 462e477.
Swedish national board of health and welfare, 2003. The Act Concerning the Ethical
Review of Research Involving Humans. SFS 2003:460. The Ministry of Education
and Cultural Affairs (2003:460).
Tveiten, S., Severinsson, E., 2006. Communication e a core concept in client super-
vision by public health nurses. Journal of Nursing Management 14 (3), 235e243.
van Manen, M., 1993. The Tact of Teaching e The Meaning of Pedagogical
Thoughtfulness. The Althouse Press, Ann Arbor, MI.
389
Van’t Hooft, M., 2005. Making Theory-Practice Connections in a Social Studies
Methods Course: A Case Study. Open gates in Teacher Education. Mofet Insti-
tute. http://vcisrael.macam.ac.il/site/eng/files/print_easy.asp?propid¼E4A016.
Welch, L., Jeffries, P.R., Lyon, B.L., Boland, D.L., Backer, J.H., 2001. Experiential
learning e integration theory and research in practice. Nurse Educator 26 (5),
240e243.
Williams, B., 2000. Collage work as a medium for guided reflection in the clinical
supervision relationship. Nurse Education Today 20, 273e278.
World Medical Association Declaration of Helsinki, 2005. Ethical Principles for
Medical Research Involving Human Subjects.
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