Background: Academic reading and writing are seen as self-evident literacy competences in most contemporary higher educations, however, whether students also are introduced to professional literacy of relevance for dentistry during their education is a question. The purpose of this study is to analyze one of the Swedish dental programmes, with respect to its design, in relation to possible content of relevance for academic and professional literacy. Secondarily, to identify and analyze Swedish dental students’ writing in an academic setting, i.e. what these students are expected to read and write, and how they write.

Methods: Data, for this ethnographically inspired case-study, was produced by observations and audio-recordings of lectures, copies of teachers’ handouts and of volunteering students’ notes, and a multiple-choice-test. Dataanalysis was made in five steps, starting with macro-level data, i.e. curriculum and syllabuses, followed by the syllabuses for the two observed modules, the teacher-provided material, analysis of the students’ notes, while in the fifth and final step, the results from the previous steps were compared, to find patterns of what students were expected to read and write, and what in the teacher-provided multimodal material that was emphasized in teachers’ talk.

Results: This study showed that students were engaged in several types of literacy events, such as reading, finding and watching videos on their learning platform, writing, and following instructions. The study also showed that there is a recurrent academic content comprised of anatomy, physiology and pathology, while the professional content comprised of patient communication and anamnesis. Further, an integrated content was found and was initiated in teacher-constructed PowerPoints and by student-questions. Note-taking patterns varied between individual students, but the general pattern for this group of students were the use of complementary notes. This type of note-taking was used to make available further descriptions of the teacher-constructed text in PowerPoints, but also an independent text describing pictures shown on teachers’ PowerPoints or the blackboard.

Conclusion: Findings from the present study reveal that students either copy text from teachers’ PowerPoint-slides, re-formulate text from teachers’ PowerPoint-slides, or write complementing text to teachers’ PowerPoint-slides. Further, the students individually choses type of note-taking based on situation. The study also revealed that the academic literacy – in the two modules during the fifth and sixth semesters of a dental education analyzed – mainly has a professional basis for reading, writing, and communication purposes. The study also showed that academic and professional literacy are closely connected through recurrent integration.

Background: The transition from upper secondary to higher education and from higher education to professional practice requires that students adapt to new literacy practices, academic and professional. However, there is a gap of knowledge regarding literacy practices in dental education. Therefore, the aim of this study was to identify what characterizes dental students’ notetaking and secondarily to determine what dental students express regarding their notetaking.

Methods: To analyze students’ perspectives about the purposes of notetaking and to examine their written notes in depth, three volunteer students, out of the 24 students that voluntarily and anonymously handed in their notes, were interviewed. The three undergraduate dental students that participated in this material-based, semi-structured interview study, framed within a New Literacy Studies approach, were on their third year (6th semester). The focus of these material-based interviews was on each student’s notes. Questions prepared for semi-structured interviews were open-ended and allowed for individual follow-up questions related to the interviewee’s answer. To analyze the outcome of the interviews a thematic analysis was used.

Results: From the material-based interviews eight themes that relate to what, how and for what purpose students write were discerned. These eight themes include professional vocabulary, core content as well as clinical examples that belong to what students read and write; multimodal accentuation as well as synthesis that belong to how students read and write; and mnemonic strategies, academic purposes, and professional purposes that belong to for what purpose students read and write.

Conclusions: Findings from the interviews indicate that the digital development, offering a variety of available tools, has expanded the notion of notetaking. This study identified that dental students’ notetaking has changed during their education from initially being synchronous, to also include multimodal and asynchronous writing, making notetaking more of a writing practice. Further, students’ writing practices seem to be motivated by their knowledge formation in relation to a subject matter, but also in relation to their experiences during clinical training. Although, our hypothesis was that the main purpose of notetaking and writing was to pass their course examinations, this study showed that students that were half-way through their dental education, are aware that literacy practices are for learning for their future profession, and not only for passing their exams.

Integrated teaching is emphasized in Swedish upper secondary vocational education and training, for managing sociocultural and historical changes related to: a) increased demands on future competent health care workers, b) educational reforms, c) altered conditions for vocational teachers’ work, and d) vocational contextualization of teaching and learning content. However, national curricula from 1970, 1994, and 2011 recommend integrated teaching as a solution without any specific concretization of what integration could or should contribute with. Thus, the aim of this thesis was to explore the realization of integrated teaching and the vocational knowing made available by integration for students at the Swedish upper secondary Health and social care program, and partly for nursing students in higher education and training. The research questions attended to how integrated teaching is realized, and what vocational knowing is made available by integration.

Theoretical point of departure was Cultural historical activity theory (CHAT), complemented with New literacy studies (NLS). The methodological framework included ethnographically inspired case studies, interviews, specifically semi-structured interviews and life-history interviews, and a systematic review. Research material was collected in 2012 and 2018. Analysis was performed with selected concepts from CHAT, and in one study also with concepts from NLS. In one study, i.e. the systematic review, GRADE CERQual was used for an assessment of confidence in the review findings.

Study results showed that integrated teaching, regardless of composition and format, made available a vocational, a general, and an expanded vocational knowing. Also, vocational contextualization of school subjects was shown to be significant as an additional teaching and learning content and as mediational means between school and workplace.

In conclusion, integrated teaching was shown to respond to the sociocultural and historical developments by making available for students an expanded vocational knowing. Also, vocational contextualization was shown to make possible for students learning knowing relevant for their future profession.

The aim for this review was to systematize, describe and critically analyse previous research concerning school-based integrated teaching for vocational knowing in nursingrelated training in upper secondary and in higher level education. Searches were conducted in four databases, two specifically for Swedish hits, and two for international hits. Also, search was made in a Nordic journal on vocational education and training. References in included studies were also assessed for further inclusion of studies. Altogether, 14 studies were included and assessed for quality and coherence with GRADE CERQual. Review findings comprised three types of integrated teaching, through embeddedness or streaks, problem-based learning, and between school and workplace; vocational knowing relating to a professional and academic context; and methodological significance for the vocational knowing highlighted in the studies. In conclusion, the methodological approach typically used in the primary studies related to a quantitative approach, which was also discerned as quality measure. The primary studies brought forward a partial understanding of integrated teaching and vocational knowing, which is dependent on the methodological approach. In order to enhance understanding about the research topic, there is a need for more studies on integrated teaching utilizing a qualitative approach.

The aim of this study was to explore what subject-integrated teaching of vocational subjects, ethics and health care, contributed with in terms of vocational knowing. The case study was ethnographically inspired and followed a group of students (16 +) and their teachers in a Swedish Health and Social Care Program while they worked with a theme unit called Death for two weeks in autumn 2012. Data comprised observations, field notes, and audio recordings of the planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. Analysis was based on concepts related to cultural historical activity theory, especially emphasizing rules, tools, actions, operations, and contradictions. Results showed three major objects emphasized in the teacher–student interaction and the tools chosen to support the subject-integrated teaching activity: vocational knowing related to vocational ethics, to everyday ethics, and argumentative skills. Manifestations of contradictions in the form of dilemmas related to the examples that teachers copied from a textbook. As these examples were mainly contextualized in everyday situations, and there are no formal ethical guidelines for nursing assistants on which teachers could rely on, teachers’ narratives were used to complement these examples. Students’ argumentative skills were emphasized and related to personal situations, in which ethical arguments for justification in vocationally relevant situations were made unclear.

The aim of this case study was to investigate what vocational knowing was made available in subject-integrated teaching of four vocational subjects in a Swedish Health and Social Care Program (HSCP). The study was composed of two separate data collections, both ethnographic. The first data collection was performed in autumn 2012 on a theme unit called VIPS, with a group of students (16 +), in a Swedish HSCP. Data comprised observations, field notes, and audio recordings of planning and teaching of the theme unit, informal discussions with teachers and students, handouts, a theme booklet, and student assignments. The second data collection was performed during spring 2018 in which life-history interviews focused on documentation were conducted with the teachers involved in the theme unit from 2012. Data comprised audio recordings and time lines. A theoretical framework and analytical work were performed with concepts from Cultural Historical Activity Theory, and from New Literacy Studies. The results indicate that the object in the teaching activity comprised vocational knowing in three areas: psychosis, ethics, and communication, and vocational literacy. Vocational contextualization of teaching was a necessary component that made available vocational knowing that contributed to the students' professional development.

The issue of this paper to scrutinise Swedish dental students’ writing in academic setting: what these students are expected to read and write, how they are expected to do this, and for what purposes they read and write.

Dental education is one of several professional programmes in higher education. The national learning outcomes stated in the Higher Education Ordinance (SFS 1993:100- SFS 2017:284) point out for example the importance of knowledge of the scientific basis as well as of proven experience for dental work, the capability of making diagnoses aw well as treating various dental diseases and malformations, but also leadership and collaboration. Such learning outcomes obviously are abstract, as they coven a whole program of 300 ECTS, and are to be somewhat more concretized in syllabuses for the various courses that together form the programme. However, as in other professional programmes within academia, part of the learning outcomes relate to content like physiology and neurology, others relate to tools, and materials used for dental work and their properties – in everyday terminology the ‘theoretical’ aspects of dental work. Other learning outcomes relate to what a dentist does – the ‘practical’ (clinical) aspects of dental knowledge. Furthermore, as becoming a dentist requires attending an educational programme, reading and writing are seen as self-evident aspects of the education. While it seems obvious that it takes time to become a skilled dentist and a degree is the necessary beginning in this direction, it seems less obvious that it also takes time to become a skilled writer in academia – where the meaning of being a skilled writer varies between disciplines (Bazerman, 1995; Blåsjö, 2004; Hjalmarsson et al. 2017; Lea & Street 1998; Airey 2011). Being a student in any higher education assumes participating in an activity that to a large extent is literacy based. To have the literacy competences and strategies needed for educational activities are crucial resources for students – these are the means for coping with literacy demands in varying but relevant situations, depending on the purpose of reading and or writing (Bazerman 1995; Dias et al. 1999; Berthén et al. 2006; Street, 2003). For students in professional programmes, there is also another aspect – today part of a dentist professional work is literacy-related: documentation of work done, reports, subscriptions, referrals – these are one type of examples of what dentists are expected to write as part of their work. Other types of writing that today are imposed on most professions, be they academic or not, are related to quality control, sustainability and security (Lindberg, 2003). Previous studies show that the transition from upper secondary school to higher education is challenging for students (Ask 2007), since the literacy practices they have experiences of differ from those they encounter in academia. Appropriating relevant academic literacies is relational – i.e. students of course need to struggle but it is also a question of what is made available to them (Edwards 2005). Characteristic for of academic literacies, whether in science (Airey 2011); engineering (Berthén et al. 2006; Hållsten 2008); in history or national economy (Blåsjö 2004), is that students nee to master different genres (a breadth), but also a progression, in terms of complexity, in order to become successful within a programme or a discipline. So the overarching question for this paper is what literacy practices that characterise one of the Swedish dental programmes? 

Method

The present study is conducted during the third year of the study programme in dentistry (SPD), during the modules “orofacial pain and jaw function 1 and 2”, at the Department of Dental Medicine, Karolinska Institutet, Sweden. The SPD has a duration of five years (300 credits) divided into 10 semesters. Each of the 10 semesters is composed by courses and the courses in modules. The third year consist of the fifth and sixth semesters. The modules “orofacial pain and jaw function 1 and 2” are closely connected with each other and are divided into two modules due to the semester break. The data analysed for this paper are modules part of the courses ”clinical odontology 2 and 3. For the overall project, the data produced are of three types: (i) curricular documents, including information given in study guides to the students; (ii) ethnographic data from lectures and clinical work (sound-recordings and field-notes during lectures, textbooks, hand-outs from the lectures, student notes from the given lectures, multiple-choice questions from the digital examination and clinical instructions); as well as (iii) interviews with students and teachers. Literacy events, i.e. what students read or write, and text-related communication (Barton 2007; Karlsson 2006; Street 2003) are mapped throughout all activities (lectures, clinical work, and examinations). During clinical work, only field-notes were taken and only one of the researchers that also were teachers in the programme took the notes since clinical work also involves patients. As a first step of the analysis, we use literacy event for identifying patterns related to text genres (Barton 2007; Street, 2003), and will pay attention to multimodal aspects (Airey 2011; Kress 2003) of text used and produced. The second step is to analyse relations between patterns, i.e. questions like What literacy practices characterize dental education? Which of these patterns are related to dental academic literacy practices, and which are related to professional dental literacy practices? Since data produced so far are from the first phase of the project, this is how far we have come.

Expected Outcomes

As some of the data production will continue during spring, we have so far concentrated on the mapping of literacy events (step 1 in the analysis), which mainly is a descriptive result. During lectures, powerpoints were used for structuring the physiological knowledge related to orofacial pain and jaw function. All slides were distributed in advance to the students via the digital learning environment used by KI. Most slides were multimodal in that they combined graphical pictures of neurological and physiological information related to the construction of a jaw and the different functions of the parts, highlighting aspects specifically related to orofacial pain. Students’ notes vary: while some made notes directly in the powerpoint, others took notes separately. During clinical work, students were given forms to fill in with the purpose of two types of documentation: medical and narrative. The analytic result will complement this descriptive result.

The study investigated subject integrated teaching and vocational knowledge in one Health and Social Care program. The material was collected ethnographically, during a period of a school semester (5 months), and analysed according to the Activity-Theoretical concepts actions, goals and tools.

The results identified five goals for subject integrated teaching: the legitimacy of Swedish as a school subject; a focus on linguistic prescriptivism; the identity of vocational subjects; a predominant medical focus in vocational subjects; and a professional language. Further six recurrent tools were identified: a fictional book; a teacher-prepared hand-out; a teacher-constructed case report; teacher-examples from health care; and linguistic rules. There was a theoretical kind of vocational knowledge with focus on language issues, on medical aspects of care, and on a professional language.

In conclusion, subject integrated teaching contributed with more than each of the specific subjects contributed with and simultaneously tensions between goals representing different subjects were found. However, tools were shared between subjects.