EU regulations mandating expanded clinical training in nursing education have intensified the demand for clinical placements and qualified supervision in Sweden, where nurse shortages are expected to persist for 15 years. The patient-oriented learning model, a work-integrated and student-centred supervision model, can enhance the educational environment during clinical practice. The aim of this study was to describe supervisors’ experiences of applying the supervision model of patient-oriented learning during nursing students’ clinical placements. This qualitative descriptive study included fifteen semi-structured interviews with supervisors, analysed using abductive qualitative content analysis. The analysis resulted in three key aspects that bridged campus-based education and clinical practice. First, engagement depended on management support, preparatory activities, and time. Second, the patient-oriented learning model encouraged structured, student-driven learning that promoted engagement and independence. Third, it fostered collaborative knowledge sharing, enhancing student preparedness and supervisory processes. Challenges included balancing structure and flexibility during busy periods, which affected the model’s use. Despite these issues, supervisors noted the model led to more organised, reflective, goal-oriented supervision, supporting professional identity, competence development, and improved student preparation for future roles. The patient-oriented learning model bridges campus and clinical practice, supporting student learning, professional development, and supervision. A key component is the binder documenting the learning process, aiding planning, reflection, and interplay between theory and practice. The model offers a structured, reflective approach benefiting supervisors and students. Organisational support and adaptation are needed to address inconsistent interpretation and limited preparation time, to support effectiveness of the model while strengthening supervisors’ competence and confidence.
Population growth, existing nursing shortages (
Clinical placement constitutes an essential component of nursing education in Sweden, which comprises a three-year programme leading to a bachelor’s degree in nursing and professional qualification as a registered nurse (
Supervisors have reported that learning outcomes are often perceived as vague and insufficiently aligned with clinical practice, with assessment tools described as too theoretical and general (
The POL model is innovative and has been developed in collaboration between healthcare and academia and is used in nursing education. The model aims to structure learning and support alignment between learning outcomes and clinical practice during clinical placements. The model is a work-integrated, student-centred supervision approach designed to help nursing students establish a professional identity within clinical practice (
The POL model is interdisciplinary and builds on the Anglo-Saxon tradition within work-integrated learning (WIL), highlighting the ongoing link between work, learning and education (
The defining characteristic of the POL model is that the student concentrates on assigned patient rooms, whereby continuity is primarily established through the relationship between the student and the patients, rather than through the student’s relationship with the supervisor. The supervisor may vary from day to day, but there is an assigned supervisor who has the overall responsibility for the student’s development and learning. The learning process is documented by the supervisor in a binder containing documents that are adapted to the learning outcomes, which function both as a visual map of the student’s expected development as well as a framework for interpreting theoretical course objectives in relation to clinical practice.
The supervisor creates a supportive environment that encourages active student participation, questioning, reflection, and consideration of multiple perspectives, while linking theory to practice, and providing opportunities for students to set goals and reflect on their experiences. Supervisors use open-ended questions, feedback, and role modelling to guide students, support personalised learning objectives, oversee documentation, and foster trust to explore uncertainties. They balance supervision with other duties, ensuring that experiential learning translates into improved patient care, which requires appropriate skills and training. A structured learning pathway, supported by documentation and a visual week-by-week overview of the student’s learning activities, enables both students and supervisors to monitor progress and identify areas for targeted development.
The connection between the POL model and PAL (Peer-Assisted Learning) lies in their shared emphasis on active engagement, reflection, and social interaction to enhance learning and professional development. While the model is innovative and designed as a work-integrated, supervisor-led model fostering professional identity development through reflection and real-world problem solving, PAL involves peer-led support that fosters active, collaborative learning among students within similar social groupings (
The POL model offers opportunities for enriching nursing education by emphasising real-world experiences and reflection to develop a clearer understanding of roles and responsibilities. It encourages active engagement and ownership of learning tailored to individual needs, promotes critical thinking, self-awareness, and continuous improvement. Its flexibility and compatibility with other supervision strategies, such as peer learning, make it adaptable across diverse clinical placements. Students have reported that the model is easy to understand, accessible, and provides a clear structure, supporting personal knowledge and professional development during clinical placements (
This study adopts a sociocultural perspective on learning, based on Vygotsky and Cole’s (1978) view of socially and contextually constructed knowledge through interaction with supervisors, professionals, and patients (
In this context, the concepts of boundary crossing and boundary objects are useful for promoting learning for supervisors and nursing students. Learning occurs as individuals or groups navigate and interact across these boundaries, gaining understanding of each other’s perspectives, practices, and ways of working. Boundary objects, material artefacts, conceptual frameworks, or shared practices, help bridge different social worlds by facilitating coordination among diverse groups (
Together, the sociocultural perspective and boundary crossing collaboration with boundary objects provide a comprehensive insight into supervisors’ experiences of understanding and applying the model during nursing students’ clinical practice. They help to highlight how supervisors can shape learning by navigating boundaries, fostering meaningful interactions, and using shared tools to promote students’ understanding and skill development.
This study aims to describe supervisors’ experiences of applying the supervision model of patient-oriented learning during nursing students’ clinical placements.
The research question was: How do supervisors describe their experiences of using the patient-oriented learning model in their supervision?
A qualitative descriptive design was employed, using semi-structured interviews (
The study was conducted in a healthcare region in western Sweden, with nearly 300,000 residents, covering both rural and urban areas. This included the two hospitals -one small and one medium-sized- within the same healthcare group, where the supervisors worked. The study included nurses from departments such as surgery, internal medicine, infectious diseases, neurological rehabilitation, and geriatric care, as these departments use the POL model. The hospitals welcomed nursing students from a local campus that hosted around 13,000 students from various nationalities, with approximately 600 enrolled in the nursing programme, whose clinical placements took place at these hospitals as part of their education.
The participants comprised 15 registered nurses (
Background information about the participants
| Variable | n=15 |
|---|---|
| Mean | 34 |
| Range | 23–46 |
| Median | 34 |
| Female | 13 |
| Male | 2 |
| Mean | 5 |
| Range | 1–19 |
| Median | 3 |
Data were collected through semi-structured interviews conducted between February 2023 and December 2024 at a time convenient for the supervisor, either in person or via video call, depending on participant preference. Participants were reminded that they could withdraw at any time without providing a reason. All interviews were audio-recorded with consent and transcribed verbatim by the first and last authors. Each interview was assigned a unique identification number to ensure anonymity, and personal information was documented separately and securely stored. All data were kept locked and accessible only to the research team.
Interviews lasted between 30 and 70 minutes and were guided by an interview guide. The interview questions focused on supervisors’ experiences with supervising based on the POL model, how they became aware of the model, and their initial expectations. The questions also address perceived possibilities and limitations of the model in supervision. During the interviews, one author (AJ) interviewed while the other (JSM) took notes. At the end of each interview, a summary was read back to the participant to ensure accurate understanding.
The research questions in this study are based on prior findings from
The primary analytical method was qualitative content analysis as described by Graneheim and colleagues (
Example
| I think the binder is more specific than the learning objectives from the university, but they go well together. It’s the goal, but in my experience, the binder is easier for the students to understand | |
| Binder is more concrete and accessible than university learning outcomes | |
| Structure for students’ learning | |
| Navigating supervision complexity - Benefits and limitations of facilitating student-driven learning |
The binder can be understood as a boundary object (
Throughout the analytical process, the researchers engaged in ongoing reflection and dialogue, oscillating between the empirical data and theoretical perspectives. This iterative process enabled the refinement of categories and the emergence of nuanced interpretations that reflected both the participants’ lived experiences and the sociocultural dynamics influencing them. Incorporating quotations from the interviews into the results served as a validity check, grounding the interpretive process in the participants’ own words. By employing an abductive approach, the analysis aimed to generate a comprehensive understanding that not only described what the supervisors experienced but also elucidated how sociocultural factors and boundary objects influenced their navigation of professional and educational boundaries. This method (
The study received ethical approval from the Swedish Ethical Research Committee (ref: 2023-00586-01; February 1, 2023). In accordance with the Declaration of Helsinki (
The results show that the supervisors perceived that the POL model strengthened their supervisor role and was an effective bridge between academic and clinical environments, promoting student-led learning and improving students’ readiness for internships. When the conditions for using the model were inadequate, it was not as easy for the supervisors to facilitate student-driven learning. Categories and subcategories are presented in
The theme, categories, and subcategories
| Knowledge in action: |
|
| Engagement and cooperation from management and colleagues - Opportunities and challenges |
Gaining legitimacy from management and colleagues Introductory preparation for learning the POL model Time allocation for using the POL model |
| Navigating supervision complexity - Benefits and limitations of facilitating student-driven learning |
Structure for the student’s learning Structure for supervision Balancing between structure and flexibility |
| Professional identity and competency development through collaborative knowledge |
Providing space for learning and knowledge development together Preparing students for professional life Strengthening the supervisory role |
Implementing the POL model required engagement and cooperation from management and colleagues. Key prerequisites included management legitimacy, access to introductory training, and formally allocated time to work with the model. These were conditions that enabled engagement and cooperation between supervisors and students during clinical placements in the nursing programme. When these conditions were lacking, it was challenging to implement the model successfully.
The supervisors explained that legitimacy, supported by management and colleagues, was essential for the successful implementation of the model. When management actively supported the model and recognised its value, this laid a solid foundation for engagement and participation among the supervisors. Establishing the model within the workplace was crucial for it to become a natural part of daily practice and for colleagues to understand the work done by the supervisors. Integrating the model into the organisation’s working methods ensured that it was not perceived as a separate initiative. All staff members needed to be informed about the model, as responsibility for the students was shared across the whole workplace.
At my workplace, at the ward, we receive a lot of support from the manager to develop as supervisors. Everyone who works here must be aware that we are using the model (8).
Initial support was required for implementing the POL model. The supervisors expressed that a well-thought-out introductory session was crucial for creating a safe and structured start, providing an opportunity to familiarise themselves with the model and its application. A verbal overview of the model, in which instructions and their implementation were clarified, proved to be a valuable element.
I received good information, but there’s always room for being a bit more prepared. Perhaps I could read more and approach it in a different way next time (11).
While some supervisors appreciated the structure that the model offered, a few expressed that it could be difficult to get started. Initial uncertainty and lack of clarity regarding how to apply the model in practice were mentioned as challenges.
After all, it was the first time we worked with this here. And I must do this to get a better grip. […] I need to practice more on this (14).
However, supervisors also noted that preparation helped reduce these difficulties. Thorough preparation was perceived to reduce uncertainty and create a clearer structure during the supervision period.
At first, it was difficult to get started, but after a while, using the model became second nature. I read up and prepared myself by going through the binder (4).
Some supervisors described preparation, such as browsing through the binder and reviewing video materials, as important steps that strengthened the supervision process. The requirement for dedicated preparation time and supervision was not always aligned with the practical realities of the workplace, yet supervisors perceived long-term benefits from investing time in preparation.
…once I used the binder, I found it to be a very good way for the student to learn (3).
Other supervisors noted that familiarising themselves with the model and working through the binders was time-consuming and not always feasible within the constraints of their regular workload. They found it difficult to prioritise these tasks and even felt the need to work overtime to be able to use the model, potentially influencing their motivation and engagement. To provide more structured and effective guidance, the supervisors expressed that they needed time to prepare. When time was lacking, the model was sometimes not used at all, and the supervisors felt that the quality of supervision was negatively affected.
I would have liked to have had more time to go through the model properly and perhaps even have it explained/…/It’s quite a lot in it [the binder], to have had more time to look through it before the student arrives on the ward (2).
The supervisors reported both advantages and limitations of the POL model in terms of facilitating student-led learning. The benefits were that the model strengthened the role of the supervisor, which facilitates students’ learning by offering a structured framework for their learning process. This structure helped to clarify and formulate individual learning objectives and encouraged students to take a more active and responsible role in their learning. The limitations were that the model could be used as a rigid template rather than a flexible tool; a balance between structure and flexibility was needed.
The supervisors explained that the POL model and the accompanying binder could be used as a tool in the planning process and described how this was perceived to facilitate a more structured and pedagogically oriented introduction for the students. The binder helped reflection and feedback became more natural and made it easier for students to structure their thoughts, helping them to integrate feedback and reflection into their daily care routines. The model’s basis in both intended learning outcomes and practical tasks made it easier to link reflection and learning outcomes to the work carried out in the clinical environment.
I think the binder is more specific than the learning objectives from the university, but they go well together. It’s the goal, but in my experience, the binder is easier for the students to understand (1).
When we sit down for reflection in the afternoon or at the end of the week, we take out the binder and check what level the student is performing at in the different parts. […] You can help the students to start up conversations with open questions, which makes it a lot easier to summarise the week (13).
The supervisors perceived the model as systematic, which made it easier for them to provide clear guidance to the students. The structured approach was seen to encourage discussions, where they discussed their reasoning and linked it to common goals in a care setting to help students develop a better understanding of learning outcomes. The structured approach was seen to encourage reflective discussions and follow-up actions.
If the student doesn’t know about the situation, I usually explain while they observe first. Then I show them how to execute the task. And then they show me. If they do something that deviates, I correct it together with the students. Then, after a while, when I see that they can handle the situation, I usually let them do the task by themselves (12).
The supervisors stated that students’ comprehension was facilitated when they focused on fewer patients, allowing supervisors to provide clearer and structured guidance to students about the intended learning outcomes. In some cases, supervisors used the model to ensure dedicated time for student support, even during periods of high workload, both during scheduled reflection meetings and through ongoing feedback integrated into the daily workflow.
They are assigned one or two patients to focus on, to read about and delve into. […] A longer period, so they get to read about the prescribed medicines […] It is better, for their learning, for them to have a few patients and get to delve into them thoroughly, while I take care of the rest of the patients (15).
Some supervisors described the POL model as easy to understand and felt that it clarified parts of the supervisory role. The model could function as a shared resource or tool that could support learning and role clarification.
It facilitates a more defined structure for the supervisors within the act of supervision. Also for the student (1).
For some, it seemed to offer a common language and framework that enhanced social cohesion among supervisors, particularly those who were new to supervising. This shared reference point may have helped to make their roles more understandable and manageable. In a few cases, the model also appeared to support the development of collective understanding and confidence.
I feel like I’ve learned a lot in my role as a supervisor. Having it clearly laid out in the binder makes it concrete—what I need to keep in mind and what to focus on when I’m supervising (13).
The core documents in the binder – the weekly overview and the progression charts – were seen by some of the supervisors as giving a clear structure that supported their communication and coordination with one another, fostering a shared identity and common goals. Some supervisors felt that the model created opportunities to reflect on their roles and practices and promoted collective learning. Additionally, they expressed that the emphasis on continuity, even with multiple supervisors or absences, meant that the model could help to ensure consistent support and knowledge transfer and reinforce professional development for the student. This was useful, for example, when a student had more than one supervisor or when one supervisor had a sick day.
The binder made it clear what step we were at, and that helped, even when I wasn’t at work. My student could be with someone else, and I could say that you can see in the binder that she’s done this (10).
Some supervisors expressed that the model and the documents in the binder could serve as tools that facilitated understanding and collaborative learning between the supervisor and student. The model was also described as a support for the supervisor to improve the students’ communication skills, as the students were expected to explain and justify their planned working methods. These explanations were often based on the stated learning outcomes. According to some supervisors, this process can help students connect theoretical reasoning to practical actions in a reflective and goal-oriented way.
You get to see the student’s progression as a supervisor, but the student can also see their own progression. You can follow the student differently when there’s documentation, and then you can use that documentation when it’s time to assess the student’s clinical placement. It’s great, like a reminder, the student has done this and knows that. It becomes clear when you and the student sit down for a reflection, and the student identifies what they need to practise or what they find important (18).
Supervisors described how the model’s usefulness partly depended on how well it fit into educational environments, where collaboration with the student and joint reflection were a strength. There is an opportunity for the supervisors to visualise and consider the student’s learning needs to support the student’s development.
I felt that you could get a very clear vision with the model, that it was a little bit easier to see the differences with it than without it, as if you needed to support the student a little more. It helped to make the students’ level of knowledge visible (13).
According to some supervisors, the model helped to create conditions for supervision that meant reduced stress and less duplication of work, which made it a valuable tool in the context of supervision.
It’s been a way that works for me to stay organised and not get stressed. So right now, it doesn’t feel as stressful (4).
However, the model contributed to the fact that the conditions for supervision were not always sufficient, which meant stress and added to the workload.
I enjoy supervising students, but the challenge is that no dedicated time is allocated. I still have to manage my group of patients. It’s about finding time to supervise while also making time for my patients. I found it a bit difficult before I had the chance to get to know the student (15).
In high-pressure situations, the consistent and full utilisation of the POL model may be compromised, leading to potential oversights and increased risks during busy periods. Without regular use, there is a risk that the model will be lost or become less effective.
…there is a risk that the model is not used consistently or fully, especially during busy periods when it can be overlooked (2).
The supervisors described that different supervisors or students can interpret situations and knowledge levels differently, which can create confusion or disagreement. It can be difficult to correctly assess students’ needs for supervision, which can lead to tutors underestimating or overestimating students’ levels of development.
It can also be difficult to place a student at a specific level; one might prefer to see them somewhere in between or… It would be if everyone viewed the same situation differently. […] Some may need more supervision than one realises or believes, yes, those kinds of things (6).
Understanding the importance of flexibility, it’s essential to recognise that focusing solely on weekly tasks can impose limitations, potentially hindering overall progress and adaptability. There is a risk that the model is used as a rigid template rather than a flexible tool. This can lead to a loss of flexibility.
…of course, there are limitations if you become fixated on what needs to be done each week (10).
This indicates that supervisors may feel constrained if they follow the structure of the model too strictly without adapting it to the specific situation.
It appears that supervisors’ reflections with students are often limited to brief moments, which can hinder a more in-depth and continuous reflection process for the student.
Like everywhere else, it’s a bit up and down how much time we have for reflections. There’s always a lack of it. You must remember that it happens when you step out of the patient’s room and go into the office… then you often say something, and that is also a reflection (14).
Working with the POL model provided improved opportunities for the supervisors to collaborate with the students in the development of knowledge. The supervisors reported that, with the help of the binder, they were better able to prepare students for professional practice, while also strengthening the supervisory role by facilitating the integration of theory, practice and reflection.
Some supervisors described the POL model and the binder as tools that helped them to integrate learning objectives and clinical practice. According to their accounts, the model contributed to a clearer awareness of the goals, which in turn enabled them to use it to guide students in working towards these goals. This was seen to promote increased interaction between theory, practice, and reflection between the student and the supervisor. In this way, the model was perceived as supporting and fostering a shared understanding of professional development between student and supervisor.
What are the intended learning outcomes? These objectives can sometimes feel abstract and difficult to understand. How should they be interpreted, and what do they mean in practice? In such cases, I believe the binder or the model acts as a bridge that helps us to make sense of them and supports a clearer understanding (12).
According to several supervisors, the model supported them in facilitating students in recognising the importance of deeper conceptual understanding beyond the immediate practical tasks.
When I was training to become a nurse, I had to adopt a different mindset, one that involved actively recalling areas where I needed to improve. At times, I would ask myself, what should I focus on developing now? Initially, my thoughts centred solely on practical skills. However, with the introduction of this model, significant opportunities emerged. It provided a structured approach to recognise areas for improvement beyond the immediate tasks at hand. The binder facilitated this process by encouraging reflection, enabling me to identify aspects of my practice that required enhancement (13).
The supervisors described how the POL model supported them in preparing for students’ future professional roles by helping them gain insight into their learning needs. This, in turn, according to some of the supervisors, enabled students to focus on relevant aspects of their future professional role.
The binder is structured, and the students understand that this knowledge will be essential in their future professional lives (18).
The model was described by multiple supervisors as a vital tool that significantly supports them in facilitating students’ learning. It enables supervisors to actively guide and promote a continuous learning process, helping students develop towards lifelong learning. By encouraging reflection, critical thinking, and a sense of increased responsibility for their own learning, the model empowers supervisors to create an environment that nurtures a learning culture rooted in ongoing growth. This environment allows students to collaboratively construct knowledge and develop self-awareness, with supervisors playing a key role in fostering these skills. Additionally, supervisors observed that students generally found it easier to identify their weaknesses, which they were encouraged to address and develop.
I think it becomes easier to recognise one’s weaknesses… It’s valuable to become aware of them, as it gives you the chance to work on them and improve (13).
Several supervisors described that the commitment to the POL model gave them increased self-confidence. Some of the supervisors saw the model as a tool that helped them strengthen the students’ self-confidence and clarify their skills, which contributed to a better understanding of competencies and expectations. In turn, these factors strengthened the supervisors in their role.
An increased independence and confidence […] With semester six students, you usually see it immediately, perhaps after two weeks; semester four students take a bit longer. However, you generally see the development in how they are themselves. Not just in each task, but overall, and they can handle different situations (14).
The supervisors described how the model had also strengthened their supervisor role, as they saw how the students, during the final assessments, had developed both learning and knowledge development. The students engaged with the model, and they used more structured methods in their learning, which showed improved readiness in their assessment tasks.
I can see a difference compared to a few years ago. Yes, perhaps they’ve always had some awareness of the goals, but now it feels like they’re more up to date, more on top of the goals. It feels like they’re prepared in a different way than a few years ago. They don’t miss the small things (15).
This study explored supervisors’ experiences of applying the POL model during nursing students’ clinical placements. The findings indicate that the model provides a structured approach to supervision that supports the integration of academic outcomes into clinical practice. Supervisors described how this structure facilitated planning, reflection, and the monitoring of student progress, thereby contributing to continuity in supervision and supporting students’ development of clinical competence and independence. According to
A key finding was that the effectiveness of the model depended on contextual conditions, including time allocation, organisational support, and supervisors’ familiarity with the model. When these conditions were in place, the model was experienced as clarifying supervisory expectations and supporting more consistent and goal-oriented supervision. This aligns with previous findings (
Structured supervision grounded in realistic, individualised goals based on assessments of student competence is recognised as essential for fostering learning and professional growth (
Supervisors believed that the model contributed to continuity and clarity in supervision while allowing for adaptation to individual needs and preparing students for future professional challenges. Previous research supports these perceptions, indicating that the model can enhance students’ independence, confidence, and engagement during placements, thereby supporting their readiness for professional practice (
The model’s emphasis on clarity, continuity, and the application of learning outcomes bridged theory and practice through concrete tasks and reflective activities. By structuring supervision around personalised goals and encouraging active participation, collaboration, and reflection, the model was described by supervisors as promoting student engagement, confidence, and independence. The binder supported planning, assessment, and social interaction, functioning as a scaffold in line with the
The foundational understanding of the model among supervisors is critical. Structured initial training and ongoing professional development are essential to boost confidence and ensure clarity in applying the model’s principles. When supervisors comprehend the pedagogical principles of the model, they are better equipped to facilitate student-centred learning that effectively links theory to practice. However, perceptions of the model’s usefulness may vary, underscoring the need for contextualised training tailored to specific clinical environments. This is in line with previous research, which emphasises the need for preparation and competence development, as well as support in interpreting learning outcomes (
The success of the model also relies on organisational support. In line with previous research (O’Neill et al., 2022), we found that organisational factors such as managerial legitimacy, access to training and allocated time are crucial for the implementation of clinical supervision in practice. Supervisors emphasised the importance of receiving an introduction to the model and having sufficient time to familiarise themselves with the tools, which fostered confidence in their application. Although some initially found it challenging to get started, many appreciated the structured nature of the model and found it to reduce stress compared to traditional supervising. Previous research indicates that supervising adds to an already high workload (
Effective application of the model involves not only following its procedural steps but also interpreting its flexibility appropriately. While the model provides clarity, rigid adherence can limit supervisors’ ability to adapt to individual student needs and situational demands. Variations in interpretation may lead to inconsistencies, highlighting the importance of ongoing dialogue, and shared understanding among supervisors. Such continuous professional exchanges help refine practice and ensure the model’s principles are applied in a manner responsive to diverse contexts.
Fostering meaningful interactions is central to the pedagogical intent of the model. Supervisors encourage active student engagement, responsibility, and reflective dialogue, which deepens learning. Such interactions are particularly relevant given the experiences that workload and lack of time for supervision affect their involvement, motivation, commitment, and satisfaction (
Taken together, the model provides a structured pedagogical framework whose effectiveness depends on flexibility, collegial, and organisational support. When implemented, the model was described as enhancing supervisors in their supervision structure and pedagogically oriented supervision. It promotes continuity in student development, supports their progression towards independence, and boosts supervisors’ confidence by clarifying roles. The model also facilitates professional identity formation and encourages collaboration and shared understanding among supervisors.
Supervisors’ understanding and strategic use of the POL model is crucial to promote optimal student learning and development. The model offers a structured, reflective approach that benefits both supervisors in their role and students. Organisational support and continuous adaptation are essential to overcome obstacles such as inconsistent interpretation and organisational constraints, such as a lack of time and opportunity for preparation. Recognising these challenges ensures that the model remains a dynamic and effective tool, ultimately fostering supervisors who are more competent and confident in their role as supervisors. The model has proved valuable in creating a clear, structured, and reflective supervision process that benefits both supervisors and students. Under suitable conditions, the binder which is used to document the student’s learning can function as a boundary tool that supports WIL, bridging campus-based learning objectives with clinical practice. At its best, the model offers a space for work-integrated learning and change. To date, the model has mainly been explored in hospital settings, and further research is needed to determine its applicability in other clinical contexts, such as primary or municipal care.
This study has both strengths and limitations. Qualitative methods are well-suited for exploring experiences (
Furthermore, the informants provided rich, in-depth data that allowed meaningful patterns and themes to emerge. The adequacy of the sample was continuously assessed, in line with guidance for qualitative research is understood as being co-constructed by the researcher’s engagement with the data rather than simply being discovered. This underscores the importance of transparency in the analytical process to enhance trustworthiness.
Participant selection via department managers may introduce bias, as managers might select participants who align with certain perceptions or who are more readily available, potentially skewing the data. Although involving nurse managers and clinical nurses facilitated recruitment but also positioned them as gatekeepers with potential influence over participation. This should be acknowledged as a limitation. However, no differences in perceptions of the model were observed between participants recruited via managers and those recruited through clinical nurses, suggesting that the recruitment strategy did not systematically affect responses.
Variations between clinical settings suggest that the implementation of the model is contextually dependent, particularly in relation to how supervision practices are organised. The study was conducted in only one small and one medium-sized hospital, which limits the applicability of the findings to other settings such as larger hospitals, different geographic regions, or healthcare systems with varying organisational cultures. Although minimal differences were observed between the two hospitals, some variation between acute care and rehabilitation units was noted, but this could not be conclusively examined due to the small sample size, indicating a need for further investigation. Consequently, caution should be exercised when attempting to transfer these findings to other contexts or populations.
Strengths of the study include the volume and richness of data, which enabled the identification of meaningful patterns and categories relevant to the research question. Inclusion of supervisors from diverse departments such as surgery, internal medicine, infections diseases, neurological rehabilitation, and geriatric care broadened perspectives and enhanced the potential applicability of the findings across clinical settings. Targeted selection of experienced supervisors ensured that the insights were informed and relevant, thus strengthening the validity of the data.
The interview process was designed to maximise trustworthiness. Participants contacted the first author via email to obtain information and arrange interviews. All received written and verbal study information and provided written consent. Flexibility in timing, location, and format (face-to-face or video call) contributed to participant comfort and data richness. The use of verbal summaries at the end of interviews allowed for clarification and added validity. Transcribing interviews verbatim and involving four researchers in the analysis process enhanced reliability, rigour, and consensus-building. The iterative analytical process, with ongoing movement between data and coding, supported depth of understanding (
The researchers’ professional backgrounds as nurses and nurse educators provided valuable contextual understanding that enriched the interpretation of participants’ experiences with the student-centred supervision model based on patient-centred care. However, this expertise also carries the risk of unconscious bias, which could potentially influence data collection, analysis, and theme identification. To mitigate these effects, the researchers employed measures such as using an interview guide and maintaining reflexivity throughout the process. These actions aimed to enhance the verifiability and overall reliability of the results. The researchers openly acknowledge that their preconceptions, shaped by their knowledge of nurse supervision models, might influence various aspects of the research process. Despite efforts to counteract bias through transparency and reflexivity, the potential remains for their expertise to subtly affect interpretations. The inclusion of a researcher with a pedagogical background added a complementary perspective, thereby enhancing analytical balance and overall reflexivity.
While the POL model shows promise in supporting effective supervision and preparing students for professional challenges, further research is needed to explore its applicability across diverse settings and the binder’s role in supervision. Such research may inform refinements and adaptations of the POL model. The model has so far only been explored in hospital settings, and further research is needed to determine its applicability in other clinical contexts, such as primary or municipal care.
The authors declare that there is no conflict of interest.