Research at PeHC

Pedagogical encounters in health care

In this research the context is mainly the clinical environment including also web based learning. The research projects are targeting learning processes related to students, supervisors, professionals and patients. The core of this research area is to expand the knowledge about learning and teaching in pedagogical encounters in the health care environment. Pedagogical encounters are defined as situations where the learner and the teacher/facilitator/professional meet and interact for the purpose of learning (Silén 2013).

The pedagogical encounters always take place in a context influencing the learning and teaching processes and course of events.

 Some central concepts investigated in this research are:

  • Authenticity in relation to learning
  • Autonomy in learning
  • Thresholds in learning
  • Professional development
  • Clinical reasoning
  • Patient safety connected to patient's learning
  • Patient participation in health care

Silén. C. Lärande inom medicin och vårdområdet. I Silén, C., Bolander Laksov, K. (ed) (2013) Att skapa pedagogiska möten i medicin och vård. Lund: Studentlitteratur

Qualitative and quantitative research approaches are used depending on the nature of research questions.

Areas of research

Two main areas are inquired into related to pedagogical encounters in health care  – Designed based clinical practice and Paradigm shift in health care.

Design based clinical practice

This research connects to Designed based research, DBR, which focuses on designing implementing and researching pedagogical encounters and learning environments building on current theoretical principles and empirical evidence. (Barab & Squire, 2004) (Dolmans & Tigelaar, 2012) Learning is studied in its real learning context (the clinic/workplace) and takes place in continuous cycles of design, implementation, evaluation and redesign according to research findings. Different parts in the cycle are stressed in different research projects. One aim is bridge theory with practice; it not only can advance a certain learning theory but also give valuable insight on how this theory can be applied to everyday practice.

Barab, S. & Squire, K., 2004. Design-Based Research: Putting a Stake in the Ground. Journal of the Learning Sciences, 01/2004, Volym 13, Nummer 1, 13(1).

Dolmans, D. H. J. M. & Tigelaar, D., 2012. Building bridges between theory and practice in medical education using a design-based research approach: AMEE Guide No. 60. Medical teacher, 34(1).

Research questions in this area
What does designed based clinical practice mean to:

Students’ learning?

Students’ profession?

Interprofessional teamwork?

Doctoral students: Angelica Fredholm; Charilaos Koufidis

Graduated doctoral students: Anna Fyrenius; Susanne Kalén; Katri Manninen, Elisabeth Bos

Supervisors: Charlotte Silén; Maggi Savin Baden; Lars Henningsohn; Martin Wohlin, Juha Nieminen. Maria Kvarnström, Janet Mattsson

Master students: Leila Nieminen; Eva Toth Pal; Karin Björklund; Sofia Wolfbrandt; Anna Ekbom; Eva Barkestad; Irum Awan; Mia Crafoord, Elin Jakobsson


  • Medical students learning physiology in PBL
  • Students learning at clinical education wards
  • Self-directed learning in clinical practice
  • Mentorship for students professional development
  • Supervisors role for students in primary health care
  • Transforming the often chaotic and opportunistic undergraduate clinical experience into a pragmatic learning environment - from passive observation to active participation
  • Learning non-technical skills in anaesthesiology
  • Supporting faculty development by an interprofessional virtual network
  • Interprofessional learning using virtual patients


Paradigm shift in health care

This research area builds on the assumption that a paradigm shift concerning information and communication is needed in health care. Instead of a focus to inform patients and deliver patient education we want to introduce the discourse of patient learning. There is a lack of knowledge about the learning processes of patients. The overall aim with this research is to provide a scientific knowledgebase that can be used to create sustainable models for how to promote patient learning based on their own needs. The impact of different format for learning, like personal encounters and web-based information, will be explored as well as the role of interprofessional team work in empowering patients to participate in their own care and health promotion. If patients have a deeper understanding of their disease/treatment it may enhance their feeling of safety, ability to participate in and manage their own care in interactions with healthcare professionals.

The ultimate goals for patient care would be that patients are able to participate and significantly be a part of decisions that are taken and to have a self-care capability to manage their illness, rehabilitation as well as promoting their own health. From the patients point of view a genuine participation can mean very much for the patients wellbeing and ability to cope in relation to illness and rehabilitation. From the perspective of health care delivery the patients’ understanding of their own illness, treatment and care is an important factor influencing patient safety. If the patients are prepared and understand procedures and the reasons behind it they can participate and improve the effectiveness and efficiency of treatments and care for all to benefit. In this process interprofessional teamwork is crucial.

Research questions in this area

What does the paradigm shift mean to:



The health care organisation?

Doctoral students: Gunilla Lööf; Lena Engqvist Boman

Graduated doctoral students: Anne Trollevik; Georg Förland

Supervisors: Charlotte Silén, Nina Anderssson Papadogiannaki, Per Arne Lönnqvist; Yvonne Wengström; Kerstin Sandelin, Karin Ringsberg, Monica Ericsson


  • Children learning from the web
  • Patient learning (breast and prostate cancer)
  • Learning centres for patients
  • Asthma school for children


Research networks



Research group members

Research group leader

Lecturer senior

Charlotte Silén

Phone: +46-(0)8-524 837 27
Organizational unit: Pedagogical encounters in Health Care

Research group members

Maggi Savin Baden Professor
Lars Henningsohn Assistent Professor
Päivi Kaila Assistent Professor
Yvonne Wengström Associate professor
Kerstin Sandelin Professor
Nina Andersson-Papadogiannaki PhD
Per-Arne Lönnqvist Professor
Karin Ringsberg Professor
Anne Trollevik Phd
Monica Eriksson Associate professor
Katri Manninen PhD
Angelica Fredholm Nilsson PhD student
Gunilla Lööf PhD student
Lena Engqvist Boman PhD student

Janet Mattsson


Susanne Kalén

Charilaos Koufidis PHD Student

Courses in medical education at PhD level

Medical educational research is an interdisciplinary field based on care sciences and behavioural sciences, particularly pedagogy but also psychology and sociology. Learning on individual and system levels in both formal education and within health care is investigated. Qualitative and quantitative research approaches are used depending on the nature of research questions. Understanding the conditions for learning within health care is a prerequisite for professional development and efficient utilization of resources contributing to improved quality of human health. Medical education researched is needed for improving quality of learning, supervision and practice within health care.

Two courses are especially designed for research in medical education

Course leader: Charlotte Silén

Introduction in Medical Education Research 6 HEC

Intended learning outcomes

After the course the student is expected to be able to:

  • Reason and argue about the significance of the Medical Education research field in relation to the Higher Educational field
  • Identify, analyze and describe different kinds of issues and phenomena that are researched in Medical Education
  • Reflect on and express similarities and differences of different research approaches and methods used in Medical Education Research

The course content includes studies of the Medical Education field especially:

  • Significance of professional educational programmes, disciplines and subjects in the medical and health care field
  • Researching different areas within medical education - student learning, teaching, course/curriculum design, assessment and evaluation
  • Researching learning and teaching in clinical education and the health care field - supervision, professional development and patient education
  • Qualitative and quantitative approaches and methods in Medical education research

Medical Education Research - theoretical basis and methodologies 4,5 HEC

Intended learning outcomes

After the course the student is expected to be able to:

  • Analyze and critique methodologies and findings within (their) own field of medical education research in depth
  • Apply and argue about relevance and meaning of theoretical knowledge/models underpinning research within (their  )own field of medical education research.
  • Compare and express similarities and differences of research approaches and theoretical underpinnings related to different fields within Medical Education Research

The course content includes studies of:

  • Theories underpinning methodologies used within the medical education field.
  • Explanatory theoretical bases relevant for the participants' own research are identified and studied in depth.

Recent publications

Silén, C., Kiessling, A., Spaak, J., Henriksson, P. The experience of physician supervisors with clerkship students: a qualitative study. International Journal of Medical Education. 2011; 2:56-63, ISSN: 2042-6372; DOI:10.5116/ijme.4e0c.23de;

Kalen S, Ponzer S, Silen C. The core of mentorship: medical students' experiences of one-to-one mentoring in a clinical environment. Adv Health Sci Educ Theory Pract. 2012 Aug;17(3):389-401

Kalen S, Ponzer S, Seeberger A, Kiessling A, Silen C. Continuous mentoring of medical students provides space for reflection and awareness of their own development. Int J Med Educ. 2012;3:236-44.

Johannesson, E., Silén, C., Kvist, J., Hult, H. Students’ experiences of learning manual clinical skills through computer simulation. Adv in Health Sci Educ 2013 ; 18(1) Page 99-114

Manninen, K., Welin Henriksson, E., Scheja, M., Silén, C. Authenticity in learning - nursing students' experiences at a clinical education ward  Health Education, 2013, 113 (2), page 132-143.

Trollvik A, Ringsberg KC, Silén C. Children´s experiences of a participation approach to asthma education.. J Clin Nurs. 2013 Jan 12. doi: 10.1111/jocn.12069.

Manninen, K., Scheja, M., Welin Henriksson, E., Silén, C. Self-centeredness or patient-centeredness–final year nursing students’ experiences of learning at a clinical education ward. Journal of Nursing Education and Practice, 2013, Vol. 3, No. 12

Barman, L., Silén, C., Bolander Laksov, K. Outcome based education enacted: teachers’ tensions in balancing between student learning and bureaucracy. Advances in Health Sciences Education 2014, DOI 10.1007/s10459-013-9491-3

Barman, L., Bolander Laksov, K., Silén, C. Policy Enacted – Teachers’ Approaches to an Outcome-based framework for course design. Teaching in Higher Education 2014 19(7): 735-746.

Manninen, K., Welin Henriksson, E., Scheja, M., Silén C. Patient-student encounters and students’ learning at a clinical education ward – an ethnographic study. BMC Medical Education 2014, 14:131

Fredholm Nilsson, A., Henningsohn L., Savin-Baden, M., Silén, C. Autonomy as Challenge and Development in Clinical Education Learning, Culture and Social Interaction Learning, Culture and Social Interaction 5  2015, 20–27

Kalen S, Ponzer S, Seeberger A, Kiessling A, Silen C. Longitudinal mentorship to support the development of medical students’ future professional role: a qualitative study BMC Medical Education  2015, 15:97

Bos E, Silén C,  Kaila P. Clinical supervision in primary health care; experiences of district nurses as clinical supervisors - a qualitative study. BMC Nursing.2015, 14:39 DOI: 10.1186/s12912-015-0089-3


Silén, C., Bolander Laksov, K. (ed) (2013) Att skapa pedagogiska möten i medicin och vård. Lund: Studentlitteratur