Kapitlet behandlar mötet med patienten och framhäver dels kommunikativa aspekter och dels etiska aspekter såsom integritet och medbestämmande.  Avslutningsvis behandlas upptaget av anamnes och status för behandling av patienten. 

Background: The review focus was to systematize, describe and critically analyze previous international research on school-based integrated teaching for vocational knowing in nursing-related education in upper secondary and higher-level education. The review questions were: a) What kind of integration was conducted within a school context in nursing-related education? b) What in terms of vocational knowing was highlighted as a result in the studies through integrated teaching? c) What was the relation between study aim and analytical method for the vocational knowing that was highlighted?

Summary of Work: Searches were conducted in two databases, EbscoHost, and ProQuest Social Sciences. Search terms ‘integrated teaching’, ‘vocational knowing’ and ‘nursing’, retrieved from the databases, were combined with “AND”. Search area was expanded by terms ‘education’, ‘curriculum’, ‘vocational’, and specified with ‘thematical integration’. Delimitations comprised admitted approaches of integration (Case Method, Problem-based Learning), and were set to scholarly, peer-reviewed articles. The first sorting comprised assessment of abstracts, while the second sorting comprised whole articles. Reference-lists of included studies were assessed for inclusion. Altogether, 14 studies were included and assessed for quality and coherence with Grade CerQual.

Summary of Results:The results showed three types of integrated teaching, integration through embeddedness or streaks, problem-based learning, and between school and workplace; vocational knowing related to a professional and academic context; and there was a methodological significance for the type of vocational knowing highlighted in the studies.

Discussion and Conclusions: Integrated teaching with professional connection was stressed as significant for vocational knowing, because of authenticity and meaningfulness. Vocational knowing of academic character required a professional contextualization for meaningfulness. The primary studies highlighted quantitative methodology as quality measure and by passed epistemological (constructivism and positivism) aspects. A quantitative method of approach was shown as the quality measure in primary studies. The notion of quality requires expansion with more qualitative studies, that focus on minor student groups and specific didactic situations for an in-depth understanding of integrated teaching and vocational knowing in nursing.

Take-home Messages: Integrated teaching is an admitted didactical approach but highly significant for vocational knowing.

The aim for this review was to systematize, describe and critically analyse previous research concerning school-based integrated teaching for vocational knowing in nursingrelated training in upper secondary and in higher level education. Searches were conducted in four databases, two specifically for Swedish hits, and two for international hits. Also, search was made in a Nordic journal on vocational education and training. References in included studies were also assessed for further inclusion of studies. Altogether, 14 studies were included and assessed for quality and coherence with GRADE CERQual. Review findings comprised three types of integrated teaching, through embeddedness or streaks, problem-based learning, and between school and workplace; vocational knowing relating to a professional and academic context; and methodological significance for the vocational knowing highlighted in the studies. In conclusion, the methodological approach typically used in the primary studies related to a quantitative approach, which was also discerned as quality measure. The primary studies brought forward a partial understanding of integrated teaching and vocational knowing, which is dependent on the methodological approach. In order to enhance understanding about the research topic, there is a need for more studies on integrated teaching utilizing a qualitative approach.

The aim of this study was to explore what subject-integrated teaching of vocational subjects, ethics and health care, contributed with in terms of vocational knowing. The case study was ethnographically inspired and followed a group of students (16 +) and their teachers in a Swedish Health and Social Care Program while they worked with a theme unit called Death for two weeks in autumn 2012. Data comprised observations, field notes, and audio recordings of the planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. Analysis was based on concepts related to cultural historical activity theory, especially emphasizing rules, tools, actions, operations, and contradictions. Results showed three major objects emphasized in the teacher–student interaction and the tools chosen to support the subject-integrated teaching activity: vocational knowing related to vocational ethics, to everyday ethics, and argumentative skills. Manifestations of contradictions in the form of dilemmas related to the examples that teachers copied from a textbook. As these examples were mainly contextualized in everyday situations, and there are no formal ethical guidelines for nursing assistants on which teachers could rely on, teachers’ narratives were used to complement these examples. Students’ argumentative skills were emphasized and related to personal situations, in which ethical arguments for justification in vocationally relevant situations were made unclear.

The aim of this case study was to investigate what vocational knowing was made available in subject-integrated teaching of four vocational subjects in a Swedish Health and Social Care Program (HSCP). The study was composed of two separate data collections, both ethnographic. The first data collection was performed in autumn 2012 on a theme unit called VIPS, with a group of students (16+), in a Swedish HSCP. Data comprised observations, field notes, and audio recordings of planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. The second data collection was performed during spring 2018 in which life-history interviews focused on documentation were conducted with the teachers involved in the theme unit from 2012. Data comprised audio recordings and time lines. A theoretical framework and analytical work were performed with concepts from Cultural Historical Activity Theory, and from New Literacy Studies. The results indicate that the object in the teaching activity comprised vocational knowing in three areas: psychosis, ethics, and communication, and vocational literacy. Vocational contextualization of teaching was a necessary component that made available vocational knowing that contributed to the students' professional development.

Based on a study of curriculum integration in Swedish upper secondary education, at a Health and Social Care Programme (Christidis, 2014), the issue of this chapter is how general subjects can contribute to vocational knowing in the interaction between teachers and students. Inspired by an ethnographic approach, classroom observations, interviews and documents formed the data, and for the analysis concepts from activity theory were used. Main results were that teachers’ and students’ experiences used in teaching focused three actors’ perspectives: those of nurse-assistants’, patients’ and relatives’. These were expressed in subject specific as well as interdisciplinary teaching of general and vocational subjects. Using subject integration made it possible for both teachers and students to explore connections between the subjects. Furthermore, subject integration contributed to one of the main goals of the Health and Social Care Programme: to develop a holistic view of the human being.

Med utgångspunkt av en studie om ämnesintegrerad undervisning på Vård- och omsorgsprogrammet (Christidis, 2014) läggs i kapitlet särskild fokus på hur de allmänna, gymnasiegemensamma ämnena kan bidra till yrkeskunnandet i samspel mellan lärare och elever i undervisningen. Data samlades in etnografiskt genom observationer av undervisningen, intervjuer, och insamling av material kopplat till undervisningsinnehållet, och analyserades med verksamhetsteoretiska begrepp. Studien visade att lärarnas och elevernas erfarenhetsutbyten i undervisningen koncentrerade sig kring tre perspektiv i vården: vårdares, patienternas och anhörigas. Dessa kom till uttryck genom ämnesspecifik och i ämnesöverskridande undervisning av de gymnasiegemensamma och programgemensamma ämnena. Ämnesintegreringen gav såväl lärarna som eleverna fler möjligheter att upptäcka samband mellan de olika skolämnena. Dessutom möjliggjorde den ämnesintegrerade undervisningen för eleverna utvecklingen av en helhetssyn på människan i enlighet med examensmålen för Vård- och omsorgsprogrammet.

The issue of this paper is to explore what vocational knowing is made available for students in Swedish upper secondary vocational education (16+) within the Health and Social Care program, with a specific focus on literacy-related vocational knowing framed by contextualized teaching (previously integration of subjects). A case study of contextualized teaching in a Swedish upper secondary school was followed ethnographically during autumn 2012 in the Health and Social Care program (year 2 of 3). Cultural-historical activity theory was used for analyzing what vocational knowing was made available and what literacy aspects that contributed to this. Teachers constructed a theme, Death, in order to work with ethical content relevant for nurse assistants. Ethical dilemmas and literacy practices (writing notes, reading aloud) were used as tools for enhancing sharing of different perspectives. The object of learning was identified as the ability to change perspectives and taking the other’s perspective in a dilemmatic situation related to caring.

The aim of the main study was to investigate subject integrated teaching in an upper-secondary Health and Social Care program and the vocational knowledge that was shaped in teaching. The aim of this presentation is to highlight a teacher-constructed case report as a tool for subject integration, the use of the tool for integration and the kind of vocational knowledge that is shaped through the use of the tool.

The material was collected ethnographically and comprised of observation on teaching, with the case report as a base, during a theme unit called “Professional language”. The material further comprised of field-notes on teaching, interviews and informal discussions, sound-recording of teaching and material handed out during teaching. The material was analysed according to Activity-Theoretical concepts of actions, goals and tools.

The results identifiedthat the case report had a vocational origin but had been modified to an educational context. This qualified the case report as a boundary object. It was used by a teacher of core-subjects in teaching to highlight content related to Swedish and to vocational subjects, but also content that related to the theme unit.

In conclusion, the use of the teacher-constructed case report in subject integrated teaching helped shape additional vocational knowledge compared to subject-specific teaching.