This paper describes the process of setting up and implementing a Teaching and Learning Observatory (TLO) in nursing practice. A TLO uses videoconferencing to connect learners in a classroom with others at a remote site and has been used successfully at the University of Nottingham in the School of Education to connect student teachers with teacher trainers. The model was adopted in the School of Nursing, building on our expertise of involving service users and carers in nurse education.

Acknowledging the international prevalence of diabetes, we wanted student nurses to learn from the perspectives of service users, carers and a diabetes nurse specialist about the life-changing issues faced by patients with diabetes starting insulin for the first time. It was decided that a TLO would be an appropriate medium to meet this aim .

Access to patients and carers in a diabetes clinic in the United Lincolnshire Hospitals Trust in the United Kingdom was gained through a diabetes nurse specialist who ran health education groups for people with diabetes. A letter was sent to the patients informing them of their appointment at the clinic and the involvement of the School of Nursing. An information sheet on videoconferencing and the process to be followed was enclosed. Patients were given the opportunity to participate in the student learning but if they declined, an alternative appointment would be offered.

Sixteen student nurses in the second year of the Diploma/BSc in Nursing, a lecturer, four patients, one carer and a diabetes nurse specialist participated in the TLO. An IT technician supported the process by liaising with the Trust's IT department, setting up the equipment and being present on the day.

In preparation for the session, the students were asked to complete a workbook on diabetes management. During the morning the students received a lecture in the classroom on the biological basis of diabetes. In the afternoon a lecture on 'Insulin Initiation' was given, which included the importance of establishing partnerships between patients and health professionals. The students were introduced to the concept of a TLO and the process of engaging in the exercise.

At a pre-determined time a video link was made between the classroom and the clinic. The students observed the skills of the diabetes nurse specialist facilitating the group and noted the questions asked by the patients. At the end of the group session, the students asked questions and the patients, carer and nurse responded to give the students an insight into the thoughts, feelings and experiences of people with diabetes. The patients were given a 'thank you' letter in recognition of their contribution to nurse education.

An evaluation of the TLO indicated that although improvements could be made in the sound quality, the students had enjoyed this method of learning and had found that their knowledge about the impact of taking insulin had increased. It is anticipated that the exercise will be repeated and developed in other areas of nursing care to enable students to develop their practice through the use of videoconferencing.