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Sjuksköterskan har en akademisk utbildning med huvudämnet vårdvetenskap och andra ämnen som medicinsk vetenskap, samhälls- och beteendevetenskaper. Detta är en grund för att ta sig an arbetet. Med dessa grundläggande kunskaper skapar sedan erfarenhetsbaserad kunskap där tyst kunskap (tacit konwledge) upptar en betydande plats ett fortsatt lärande. För en kontinuerlig kompetensutveckling och för att kunna medverka till förbättringar i vården, krävs också att sjuksköterskan arbetar på en lärande arbetsplats.

Detta kapitel redovisar pedagogiska grunder för sjuksköterskans pedagogiska vårdarbete. Kapitlet beskriver översiktligt pedagogik, kunskap, kompetens och lärande, speciellt med tanke på sjuksköterskans arbete. Boken har sin tyngdpunkt på lärande i vårdkontexten.

Detta kapitel tar upp pedagogiska perspektiv och teorier om lärande, framför allt när det gäller individens lärande. De fyra grundläggande perspektiv, som också interfolieras med teoretiska resonemang är:

1. Lärande genom förmedling.

2. lärande genom självstyre.

3. Lärande genom dialog.

4. Lärande - en helhetssyn.

AIM: To investigate both quantatively and qualitatively the differences between participation in team-based visist (TBVs) an perceived needs for TBVs from the perspectives of healthcare professionals, in the context of the Swedish three-tier national child healthcare program.

METHODS: A studfy-specific qustionnaire, including multipel-choice questions with fixed and free-text response options, was developed and used. To capture healthcare professionals' experiences and find explanations for the quantitative results in qualitative data, a convergent parallel mixed-methods study design was ued. Descriptive statistics and Mcnemar's test were used to analyze the quantitative data, and content analysis was used to analyse the qualitative data.

RESULTS: Healthcare professionals perceived the needs fot TBVs in the Swedish child helathcare services (CHS), especially in cases with complex needs. The largest differences between the perceived needs for TBVs and experienced TBVs was seen for targeted TBVs on indications associated with psyjosocial problems. The quantitative findings were explored by the qualitative findings. Both individual and organisational factors influenced TBVs.

CONCLUSION: Perceived needs for TBVs in Swedish (CHS) exceeds ints existence. Healthcare professionals require TBVs delivered by interprofessional teams, in line with proprtionate universalism. To realize this, organisational structurer (e.g. co-location and clear instructions on how to distribute TBVs) and human resources (e.g. psychologists and social workers) are needed. 

Kapitlet fokuserar sjuksköterskans pedagogiska arbete med patient och närstående. Samspelet mellan sjuksköterskan och patienten samt anhörig är inte "symmetriskt" vilket ofta leder till att sjuksköterskan är "lärare" och de övriga "elever". Samtidigt kommer rollerna ibland att vara ombytta och sjuksköterskan är den som lär sig i samspelet. För att sjuksköterskan ska kunna förverkliga en personcentrerad vård är det viktigt att hen arbetar utifrån medvetna pedagogiska val.

Förändringar i samhället, i sjukdomsbilder och i behandlingsmöjligheter ställer kontinuerligt krav på förändringar och förbättringar i vården. I allt detta har sjuksköterskan en nyckelroll. Ett kontinuerligt lärande i vården är ofrånkomligt och i detta har sjuksköterskan en viktig roll att spela som omvårdnadsspecialist och ofta i en position som ledare. Hen är alltså i mångt och mycket en förändringsagent.

Background Globally, interprofessional teamwork is described as a key method to promote health and prevent illness in children, namely, to achieve the goals of Child Healthcare Services (CHS). However, how teamwork should be designed within CHS to achieve the goals is unclear. This study aimed to investigate healthcare professionals' perceptions about 1) taking part in interprofessional teamwork, 2) team characteristics, and 3) whether the perceptions were related to professional affiliation or workplace. Methods A national cross-sectional survey was conducted using a web-based study-specific questionnaire sent to all accessible nurses, physicians, and psychologists in Swedish CHS (n = 3552). The response rate was 31.5%. To identify possible associations, logistic regressions were conducted. Results Almost all respondents, 1096/1119 (97.9%), reported taking part in some type of interprofessional teamwork within the Swedish CHS. Among those, the most common was team-based visits (82.2%). It was perceived that performing team-based visits resulted in fulfilled goals, expertise exceeding individual team members' competences, provision of high-quality care, and meeting children's and families' needs, to a greater extent, than if not performing team-based visits. Correspondingly, working as a team in parental groups was perceived as resulting in fulfilled goals, meeting the needs of children and their families, and continuity within the team to a greater extent than if not working together in a team. Professional affiliation was associated with different perceptions and types of teamwork. Family Centers were positively associated with all types of teamwork as well as continuity within the team. Conclusions Healthcare professionals' perceptions about team characteristics were associated with professional affiliation, workplace, and type of teamwork (defined as team activities) within the CHS. Professionals within Swedish CHS, taking part in team-based visits and in interprofessional teamwork in parental groups, perceived that the team fulfilled its goals and met the needs of children and families to a greater extent than professionals not taking part in these types of teamwork. Professionals at Family Centers were more likely to work in teams in different ways. Knowledge about interprofessional teamwork for individuals and groups in Swedish CHS might also be valuable in other healthcare settings, dealing with complex needs.