title: Supervisors' pedagogical role at a clinical education ward - an ethnographic study.
abstract: BACKGROUND
  Clinical practice is essential for health care students. The supervisor's role and how supervision should be organized are challenging issues for educators and clinicians. Clinical education wards have been established to meet these challenges and they are units with a pedagogical framework facilitating students' training in real clinical settings. Supervisors support students to link together theoretical and practical knowledge and skills. From students' perspectives, clinical education wards have shown potential to enhance students' learning. Thus there is a need for deeper understanding of supervisors' pedagogical role in this context. We explored supervisors' approaches to students' learning at a clinical education ward where students are encouraged to independently take care of patients.
  
  
  METHODS
  An ethnographic approach was used to study encounters between patients, students and supervisors. The setting was a clinical education ward for nursing students at a university hospital. Ten observations with ten patients, 11 students and five supervisors were included in the study. After each observation, individual follow-up interviews with all participants and a group interview with supervisors were conducted. Data were analysed using an ethnographic approach.
  
  
  RESULTS
  Supervisors' pedagogical role has to do with balancing patient care and student learning. The students were given independence, which created pedagogical challenges for the supervisors. They handled these challenges by collaborating as a supervisory team and taking different acts of supervision such as allowing students their independence, being there for students and by applying patient-centredness.
  
  
  CONCLUSIONS
  The supervisors' pedagogical role was perceived as to facilitate students' learning as a team. Supervisors were both patient- and student-centred by making a nursing care plan for the patients and a learning plan for the students. The plans were guided by clinical and pedagogical guidelines, individually adjusted and followed up.
authors.affiliation: Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Katri
authors.initials: K
authors.lastname: Manninen
authors.affiliation: Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden.
authors.forename: Elisabet Welin
authors.initials: EW
authors.lastname: Henriksson
authors.affiliation: Faculty of Social Science, Department of Education, Stockholm University, Stockholm, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Scheja
authors.affiliation: Karolinska Institutet, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Silén
keywords: Balancing patient-care and student learning; Clinical education ward; Pedagogical challenge; Supervisory team