Tensions experienced by student and care professionals in a learning and innovation network: a responsive evaluation using storytelling.

Background: Learning and innovation networks are collaborative initiatives between educational and healthcare institutions aimed at integrating the learning of students and care professionals and improving the quality of care through shared practices. Aim: This study aims to explore how care professionals and students experience learning and working within a learning and innovation network. Methods: Using a responsive evaluation, we collected data in four iterative phases: (1) interviews with four students and two care professionals to identify themes; (2) development of four fictional stories illustrating tensions based on interview data and practical experience; (3) focus groups with students and care professionals to validate and refine the stories; and (4) a mixed stakeholder group discussion to reflect and start to formulate improvement actions. Thematic analysis was used across all phases. Results: Participants experienced various tensions, and one of the primary challenges for both students and care professionals was to balance the time allocated between learning activities, care provision and innovation projects. Students faced role ambiguity when performing unsupervised care tasks, feeling part of the team but also vulnerable in their learner status. Care professionals struggled with time constraints and competing demands between patient care and student supervision, which sometimes led to them withdrawing from guiding students. Another tension emerged around engaging in quality improvement. While participants recognized the importance of improving care, engaging in this progress was hindered by a lack of shared understanding of optimal rehabilitation practices and unclear responsibilities regarding implementing innovation. The student-dense environment, though rich in learning potential, heightened these tensions due to differing expectations and unclear roles. Conclusion: Although learning and innovation networks offer valuable opportunities for mutual learning and improving care, they also introduce tensions that need to be acknowledged and addressed. Managing these tensions, especially around time division, role clarity and a shared vision for improving care, is essential for creating sustainable learning and innovation climates in practice.