The theoretical foundations of relational pedagogy run deep. The approach is grounded in the ethics of care, most famously articulated by Nel Noddings, and in dialogical philosophy, particularly Martin Buber’s distinction between I-Thou relationships—characterised by authenticity, openness, empathy, and presence—and I-It relationships, marked by detachment and objectification. It also draws on Emmanuel Levinas’s ethics of responsibility to the other. Within this tradition, education is conceived as a lifelong relational process shaped through ethical encounters between persons, in which knowledge, learning, and teaching exist within a shared reality co-constructed by students and educators. The educator’s intuitive and ethical responsiveness to students’ situated experiences becomes nothing less than a moral core of pedagogy. Rather than treating students as passive recipients of transmitted content, relational pedagogy invites them to become active partners in the learning process, establishing trust, engagement, and reciprocity as the mechanisms through which understanding develops.

The empirical case for such an approach is considerable. Pedagogical relationships shape how students perceive their study environment, influence academic achievement, and have even been regarded in some research as more significant than the lecturer’s subject knowledge. Yet contemporary academic cultures—defined by workload pressures, expanding student numbers, and mounting administrative demands—often constrain lecturers’ capacity to engage relationally. Mental health and well-being problems are reported across the academic hierarchy, from early-career faculty to senior positions, reflecting widespread institutional and structural stressors. Students face parallel challenges. Recent Swedish studies indicate that final-semester students in healthcare and social work programmes reported declining sense of coherence and reduced health-promoting behaviours over time, while students across cohorts continued to report low general health and well-being. These converging trends, Lood argues, highlight an urgent need for educational environments that support meaningful relational engagement, belonging, and shared responsibility.

Occupational therapy is a particularly fertile ground for this pedagogical philosophy. The discipline’s core values—meaning-making, participation, and relationality—mirror the principles of relational pedagogy almost exactly. Students are expected to develop not only theoretical and practical knowledge but also relational capacities such as reflexivity, presence, and attuned communication, capabilities that echo the therapeutic use of self long described in clinical practice. The approach also overlaps with sociocultural learning theory, which frames learning as participatory and dialogical, and with constructivist perspectives that view learners as active agents constructing knowledge through experience and reflection. Relational pedagogy builds on these traditions by foregrounding the ethical and affective dimensions of educational encounters, positioning relational quality as a key mechanism through which students engage, participate, and ultimately learn. It resonates too with broader shifts in healthcare toward person-centred and integrated care, reinforcing the importance of cultivating relational competence before practitioners ever reach a clinic.

To explore how these ideas translate into everyday teaching, Lood conducted four individual interviews with senior lecturers at a Swedish occupational therapy programme built on student-activating pedagogy, which encourages students to actively search for knowledge and take responsibility for their own learning. The lecturers had between nine and thirty years of teaching experience, and the interview guide addressed what relational pedagogy means, views on lecturer-student relationships, relationships in an era of digitalised education, and the facilitators and barriers to human connection and dialogue in higher education. Transcripts were analysed using qualitative content analysis as described by Graneheim and Lundman, with preliminary categories refined through collegial discussion, engagement with previous literature, and reflexive notes informed by the author’s own eight years of teaching experience. The analysis yielded two central categories: learning as a co-created occupation, and relational pedagogy as a foundation for deep learning and professional development.

The first category reframes learning itself as a shared, jointly produced activity. Lecturers described relational pedagogy as an active, mutual process built on engagement, trust, and responsiveness—a deliberate shift away from traditional, authoritative teaching toward collaboration and participation. Lecturers and students share responsibility for the learning process, and outcomes emerge through dialogue rather than unilateral delivery. One lecturer summarised this reciprocity as “a giving and taking all the time,” capturing the distributed expertise and shared decision-making at the heart of the approach. In practice, this meant cultivating safe and inclusive environments by being relationally present, inviting students’ experiences into discussions, and using dialogical prompts to stimulate two-way communication. As another lecturer put it, “It concerns not just the what but the how in our work”—pedagogical content and relational quality were treated as inseparable. Importantly, this relational work extended beyond individual lecturer-student encounters to the wider relational ecology of the programme, including relationships within and between student groups and among colleagues, where shared pedagogical aims and collegial coherence reinforced collaboration and collective responsibility.

The second category connects relational teaching to deep learning and professional identity formation. Deep learning, in this framing, means the integration of theory and practice, critical reflection, and understanding that becomes personally meaningful within occupational therapy contexts. One lecturer described the shift from factual acquisition toward professional and personal becoming: “It is about getting the students to understand that it is not only about knowledge, but also about a different approach. To develop as a human being and that it is a road you travel together.” This echoes established research showing that supportive, dialogical environments promote deep approaches to learning, characterised by integrated understanding rather than superficial reproduction. Lecturers also noted that modelling relational engagement—presence, attentive listening, ethical sensitivity—positions relational competence as an integral part of becoming an occupational therapist. The benefits flowed back to educators as well: relational encounters sparked reflection on teaching values and were described as sustaining and mutually enriching, with students reportedly able to “feel when we talk to each other and have shared goals.”

Yet the study is equally clear about the forces working against relational pedagogy. Large cohorts and heavy workloads limited opportunities for dialogue and personalised engagement. Hybrid and digital learning formats weakened relational attunement, with lecturers mourning the loss of body language, informal pre- and post-class interactions, and spontaneous dialogue, and expressing uncertainty about students’ engagement when cameras stayed off. These challenges align with concerns raised by Felten and Lambert that hybrid education can intensify disconnection if relational structures are not deliberately designed. Lecturers responded experimentally, with small-group formats, guided reflection, and open online “drop-in” spaces that supported informal contact—and proved valuable on campus as well. Institutional pressures compounded the difficulty: efficiency demands, standardisation, and surveillance-oriented performance cultures reduced the time and space needed for relational teaching. The approach also exacted a personal toll, demanding emotional labour and vulnerability as lecturers balanced openness with professional boundaries and navigated group conflicts under workload pressure.

The overall conclusion is that relational pedagogy must be understood simultaneously as practice, ethos, and challenge. It can be enacted through intentional strategies—attentive listening, shared reflection, relational availability, and facilitation of peer collaboration—and it demonstrably supports deep learning and professional formation. But its sustainability depends on institutional and collegial support, because it requires time, emotional investment, and pedagogical intentionality rather than discretionary individual effort. Lood argues that higher education systems should move beyond competitive and individualistic approaches and recognise the relational dimensions of teaching and learning as central rather than peripheral. When institutions acknowledge the time, care, and emotional labour involved, lecturers can draw on their professional and experiential knowledge to treat students as credible contributors of knowledge, cultivating inclusive and collaborative learning environments that align with occupational therapy’s core values—and offering a model that other health professional disciplines, and perhaps higher education more broadly, would do well to study.

Subject of Research: The application of relational pedagogy in occupational therapy education

Article Title: On relational pedagogy in occupational therapy education: What it is and why it matters

Article References: On relational pedagogy in occupational therapy education: What it is and why it matters. (n.d.). https://doi.org/10.1080/11038128.2026.2613622

Image Credits: AI Generated

DOI: 10.1080/11038128.2026.2613622

Keywords: relational pedagogy, occupational therapy education, higher education, ethics of care, dialogical philosophy, student engagement, collaborative learning, deep learning, professional identity, digital learning, emotional labour, co-creation of knowledge

The research team, led by Yuqing Zhao of Tianjin Medical University Cancer Institute and Hospital together with colleagues from Tianjin Second People’s Hospital, Tianjin University of Traditional Chinese Medicine, and Tianjin Medical University, set out to answer a deceptively simple question: what kind of clinical teaching do nursing interns actually want? The question carries considerable weight. Undergraduate nursing interns are becoming an increasingly vital component of the nursing workforce in China and internationally, and the quality of the clinical internship, the critical transition from classroom theory to bedside practice, has emerged as a pressing concern for nursing educators worldwide.

Methodologically, the study took the form of a descriptive qualitative investigation. The researchers used purposive sampling to recruit 21 undergraduate nursing interns, aged between 20 and 23, all of whom were in the clinical practice phase of their training in July 2025. Each participant took part in a semi-structured interview, a format that gives respondents room to speak in their own words while ensuring that key topics, anticipated influencing factors, preferred teaching methods, mentor behaviors, expectations about the structure and current state of clinical placements, and additional educational needs, were systematically explored. The interview transcripts were then analyzed using Colaizzi’s seven-step method, a well-established approach to thematic analysis in nursing research that moves from careful reading of raw text through extraction of significant statements, formulation of meanings, clustering of themes, and eventual validation of the resulting thematic structure against the original data.

What emerged from that analysis were three primary themes describing the clinical teaching traits preferred by undergraduate nursing students. The first, which the researchers describe as relational pedagogy as motivational catalyst, captures the interns’ desire for teaching grounded in personal connection, encouragement, and emotional support rather than command and correction. The second theme, experiential integration of knowledge, reflects a strong preference for learning that fuses doing with knowing: interns valued mentors who could translate abstract theoretical content into concrete bedside moments and, conversely, who used real clinical events as springboards for deeper conceptual understanding. The third theme, expanding the learning ecology beyond skills, points to an appetite for growth in dimensions that traditional skills checklists do not touch, including professional identity, communication, ethical judgment, and the psychological demands of caring work.

The framing of that first theme is perhaps the study’s most striking finding, because it signals what the authors call a shift from hierarchical to relational pedagogy. In many clinical settings, including those shaped by longstanding cultural traditions of deference to senior clinicians, the teaching relationship has historically flowed in one direction: the expert speaks, the novice complies. The interns in this study described something else. They described teaching that works as a catalyst for motivation, in which the educator’s personal qualities, their warmth, their patience, their visible enthusiasm for the profession, ignite the student’s own desire to learn. In this view, the clinical teacher is not merely a transmitter of technique but a role model whose character itself functions as a pedagogical instrument.

The second theme, experiential integration, speaks directly to one of the oldest problems in health professions education: the persistent gap between what students learn in lectures and what they encounter at the bedside. The interns participating in the study indicated that they learn best when knowledge and experience are deliberately intertwined, when a mentor pauses at the bedside to connect a textbook principle to the patient in front of them, or when a post-procedure debrief converts a hands-on moment into durable understanding. This preference aligns with a broad body of educational theory holding that learning is most effective when it is situated in authentic practice, but the study grounds that abstraction in the specific voices and priorities of Chinese nursing interns navigating their formative clinical months.

The third theme broadens the frame considerably. The interns reported unmet multidimensional learning needs that extend well beyond technical competence. They wanted support in developing as professionals, in understanding the ethical texture of nursing work, in communicating with patients and families, and in managing the emotional labor inherent in caring for people at vulnerable moments of their lives. This finding suggests that clinical placements, as currently structured, may be underdelivering on dimensions of professional formation that interns themselves consider essential. The learning ecology of the clinical environment, the study implies, should be deliberately expanded to cultivate these capacities rather than left to chance.

The implications reach into the practical machinery of nursing education. The authors conclude that the cultivation of nursing professionals depends fundamentally on clinical educators, whose personal qualities can stimulate student enthusiasm for learning, and that this motivational potential must be channeled through progressive teaching methods while attending to the multidimensional clinical learning needs of students. Done well, they argue, this combination helps interns build a coherent professional knowledge system during clinical practice, allowing clinical education to transcend traditional frameworks and achieve deeper integration. More concretely, the findings are intended to provide a theoretical basis for designing selection, training, and management programs for clinical teaching nurses, calibrated to the Chinese cultural context in which those programs will operate.

The study’s timing matters. Health systems across the globe are grappling with nursing shortages, and undergraduate nursing interns are shouldering a growing share of frontline care capacity. At the same time, the internship represents the single most consequential phase of nursing education, the point at which theoretical knowledge either solidifies into professional competence or frays under the pressures of real practice. If the quality of that transition depends heavily on the relational and pedagogical skills of clinical teachers, then investing in those teachers, choosing them well, training them deliberately, and managing their teaching roles thoughtfully, becomes a strategic priority rather than an administrative afterthought.

The research also carries a methodological contribution. By applying Colaizzi’s seven-step analysis to a purposively sampled cohort and reporting the work in line with qualitative research conventions, the team offers a replicable template for exploring learner preferences in other institutions, other regions, and other healthcare cultures. The picture that emerges is of a generation of nursing students who respect expertise but respond most powerfully to educators who teach as relationships first and hierarchies second, who turn every clinical encounter into an integrated learning opportunity, and who take seriously the full breadth of what it means to become a nurse. For educators and hospital administrators, the message is clear: the future of clinical nursing education may belong less to the loudest authority in the room than to the most motivating presence at the bedside.

Subject of Research: Clinical teaching preferences of undergraduate nursing interns in China

Article Title: Clinical teaching preferences of undergraduate nursing interns in China: a descriptive qualitative study

Article References: Zhao, Y., Zhao, S., Zhang, W., Huo, Q., Wang, M., Sun, X., Li, H., Zhao, Y., & Lu, Q. (2026). Clinical teaching preferences of undergraduate nursing interns in China: a descriptive qualitative study. BMC Nursing. https://doi.org/10.1186/s12912-026-05346-9

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05346-9

Keywords: nursing education, clinical teaching, undergraduate nursing interns, qualitative research, mentorship, China, nursing workforce, relational pedagogy, clinical internship, teaching methods, nurse mentors, health professions education