Handledning som undervisningsform i sjuksköterskeprogrammets praktik : en beskrivning av variation i innebörd

Sammanfattning: Swedish nursing education has its roots within a tradition of vocational training in clinical practice. Supervision is commonly used in the practical parts of the education. The aim of the study was to explore, describe and understand the content and meaning of supervision expressed by student nurses and their supervisors. A complementary aim was to analyse and report on the research process as a background to the result which developed progressively. The research was carried out within the phenomenographic research tradition, using contextual analysis. Twenty-four student nurses and their supervisors from three nursing departments were interviewed individually on the basis of their most recent period of practice, one of the three main periods of practice in the programme, lasting from 4 to 11 weeks. The interviews were transcribed and data were analysed by explorative interpretation and grouped according to whether interviewees were giving accounts of past experiences or expressing present conceptualisations. Significant statements expressing present conceptualisations were analysed specifically. All other data were analysed as background in delimiting the content and form of conceptions of supervision. The main result showed that students and supervisors primarily gave supervision the meaning of a human relationship of an existential nature, an asymmetric, both formal and informal social relationship which includes judgement. The result also showed more and less reflective approaches to what was to be learnt. Three types of conceptions of supervision representing different directions were found: Tradition-Oriented Transferring of Nursing Tasks, Goal-Oriented Solving of Nursing Problems, and Student-Oriented Exploration of the Nursing Profession. The two first types were considered to correspond to reproductive learning and productive learning and the third type to creative learning. Seven parts of supervision were identified. The most important part was ”questioning” and whether the questioning had the character of control or reasoning. The results indicated too much adaptation to traditional nursing as a process of cultural reproduction and a lack of a higher degree of scientific training, in the sense of the possibility of creating meaning by exploration and deep learning. It appears that the supervisory relationship gives the supervisor a special ethical responsibility in creating a communicative situation with space for critical thinking by allowing different perspectives to be expressed, questioned and discussed.