title: Clinical supervision in primary health care; experiences of district nurses as clinical supervisors - a qualitative study.
abstract: BACKGROUND
  Learning in the clinical environment is an important part of nursing education. Several recent studies focusing on clinical learning have been based on hospital settings. Little is known about primary health care (PHC) as clinical environment where district nurses (DNs) or nurses supervise students. It is important to understand more about opportunities and difficulties in supervising in this area in order to develop PHC as an optimal learning environment for nursing students. The main objective of this study was to gain an understanding of supervisors' experiences of supervising undergraduate students at PHC units.
  
  
  METHODS
  A qualitative research approach was used to collect data and analyse supervisors' experiences. Six focus groups were carried out with 24 supervisors. Focus group data were audio-taped. The data were analysed using an inductive content analysis.
  
  
  RESULTS
  Three themes illustrated supervisors' experiences: abandonment, ambivalence and sharing the holistic approach. Supervisors felt abandoned by their managers, colleagues and nurse teachers from universities. They experienced ambivalence due to simultaneously being supervisors for students and carrying out their daily work with patients. At the same time, they were proud to be DNs and willing to share their unique role to apply a holistic approach and continuity in patient care with students.
  
  
  CONCLUSIONS
  When supervising students in PHC, social support and communication between supervisors and their colleagues and management as well as nurse teachers need to be taken into consideration both at universities and at primary health care units.
authors.affiliation: Karolinska Institutet, Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Alfred Nobels Allé 12, SE-141 83, Huddinge, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bos
authors.affiliation: Karolinska Institutet, Department of Learning, Informatics, Management and Ethic, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Silén
authors.affiliation: Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden.
authors.forename: Päivi
authors.initials: P
authors.lastname: Kaila
keywords: District nurse; Primary health care; Qualitative content analysis; Supervisor