Staffan Josephsson

People’s stories matter in health and social care. But how do patients create meaning in relation to the care and support they receive? Today, concepts such as participation, co‑creation, and patient involvement are widely used in research, education, and clinical practice. Yet it is not always clear what these concepts mean in everyday practice, or how evidence‑based care can be combined with patients’ own perspectives and interpretations.

In my work, together with colleagues, I draw on philosopher Paul Ricoeur’s ideas about narrative, action, and interpretation. We focus on empirical research on person‑centred practices within health and social care.

Based on long‑term qualitative studies of older people’s everyday lives, and in close collaboration with residential care facilities and geriatric services, our projects have developed a theoretically grounded and practically useful model for Narratively Engaged Care (NEC).

Although narrative perspectives are central to person‑centred care, there is still a lack of effective ways to integrate narrative meaning‑making into everyday routines and organisational structures. Building on Ricoeur’s theory and our long‑standing research, we have developed a theoretical framework — “narrative‑in‑action” — that describes how lived experience and professional knowledge can be combined to strengthen participation, dignity, and quality of life.

With support from the research council Forte, we are now developing a knowledge resource for eldercare organisations that aim to work more person‑centred and strengthen their competence in meeting people through their everyday stories, thereby enhancing older adults’ influence over their daily lives.

My pedagogical positionality has been shaped by my family’s social mobility—from small‑scale farming with limited access to education to positions within the academic middle class. My educational values are further informed by my family’s long-standing engagement in popular movements, including the Scandinavian folk high‑school movement and South American liberation theology. These influences have fostered in me a view of human beings as both vulnerable and capable, and I reject any form of disdain for weakness.

My current educational practice is grounded in theories of learning as a constructive process and in perspectives that highlight the social nature of learning (Piaget 1970; Mogensen 1994). From these theoretical foundations, I regard students’ active work to integrate theoretical knowledge with experiences from lectures and clinical practice as central to the learning process. The role of education, therefore, is to create conditions that support such integration and to cultivate students’ readiness to generate new knowledge when they encounter unfamiliar or complex professional situations.

In my teaching, I have consistently applied both problem‑oriented and problem‑based pedagogical approaches. These approaches share a student‑centred perspective informed by contemporary learning theories and foreground the professional communities of practice into which students are entering. Importantly, they are closely aligned with working methods used in clinical occupational therapy, thereby enhancing the relevance and transferability of learning between university and fieldwork environments.

Ongoing critical reflection and evaluation have been key components of my pedagogical work (Runge et al. 2000; Josephsson, Heuchemer & Thornberg 2006). I view this reflective stance as essential for engaging students in a critical professional culture and for supporting the development of evidence‑based practice (Lave & Wenger 1991). Such reflection must apply not only to clinical practice but also to the pedagogical methods used in education. Therefore, I consider it vital continually to scrutinize, question, and refine the teaching formats that shape students’ learning.

To foster genuine participation and engagement among both students and colleagues, it is necessary to make the theoretical and ideological underpinnings of pedagogical methods explicit. With this in mind, I have initiated and developed critical spaces within the courses I teach—framed as third spaces—where students and teachers can collaboratively reflect on and discuss the pedagogical approaches used in the programme. These meeting places have been instrumental in strengthening transparency, shared understanding, and collective pedagogical development.