BackgroundClinical teaching is a complex learning situation influenced by the learning content, the setting and the participants' actions and interactions. Few empirical studies have been conducted in order to explore how clinical supervision is carried out in authentic situations. In this study we explore how clinical teaching is carried out in a clinical environment with medical students.MethodsFollowing an ethnographic approach looking for meaning patterns, similarities and differences in how clinical teachers manage clinical teaching; non-participant observations and informal interviews were conducted during a four month period 2004-2005. The setting was at a teaching hospital in Sweden. The participants were clinical teachers and their 4th year medical students taking a course in surgery. The observations were guided by the aim of the study. Observational notes and notes from informal interviews were transcribed after each observation and all data material was analysed qualitatively.ResultsSeven pedagogical strategies were found to be applied, namely: 1) Questions and answers, 2) Lecturing, 3) Piloting, 4) Prompting, 5) Supplementing, 6) Demonstrating, and 7) Intervening.ConclusionsThis study contributes to previous research in describing a repertoire of pedagogical strategies used in clinical education. The findings showed that three superordinate qualitatively different ways of teaching could be identified that fit Ramsden's model. Each of these pedagogical strategies encompass different focus in teaching; either a focus on the teacher's knowledge and behaviour or the student's behaviour and understanding. We suggest that an increased awareness of the strategies in use will increase clinical teachers' teaching skills and the consequences they will have on the students' ability to learn. The pedagogical strategies need to be considered and scrutinized in further research in order to verify their impact on students' learning.

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BACKGROUND: The job demands on nurses have increased. Conflict between work life and family life may lead to stress and lower work engagement. Consequently, nurses may choose a different career path or leave the profession. OBJECTIVE: Examine the extent to which perceived job demands (interpersonal conflicts at work and workload), work engagement, work-family conflict and family-work conflict are associated with turnover intentions, and examine a possible moderating effect of work-family conflict on the relationship between the intention to leave the nursing profession, job demands and work engagement. METHODS: Cross-sectional study using Hobfoll’s Conservation of Resources theory. Data were collected from a sample of 807 registered nurses (RNs) from western Sweden. Tests of moderation were conducted using the PROCESS software macro developed by Andrew F. Hayes. RESULTS: Work-family conflict was a significant moderator in the relationship between the intentions to leave the nursing profession and work engagement as well as interpersonal conflicts at work. Low work engagement, high work-family conflict and high job demands intensify turnover intentions in well-educated and well-experienced nurses. CONCLUSIONS: The results imply that work-family conflict has a greater impact when RNs experience lower work engagement. In other words, higher motivation implies a lower moderation effect of work-family conflict. Managers should promote a positive working climate by listening to and providing nurses with opportunities to develop their skills. By so doing, managers can gain better understanding of nurses’ resources, knowledge and work situation, thus strengthening nurses’ confidence and ability to practice their profession.