Background <p>Patients’ knowledge and participation are essential for safe care. Nurses must enhance their pedagogical knowledge and skills to support patients to understand their health and become active partners in care. Pedagogical activities were implemented in a specialist nursing program to support this learning. The aim of this study was to explore experienced nurses’ understanding of the meaning of pedagogical encounters with patients in cancer care, as well as how they think and act during these encounters to support patients’ learning.</p> Methods <p>Interpretative qualitative study using individual interviews with nurses (<i>n</i> = 8) undergoing specialist training. An interview guide along with the nurses’ written assignments during the specialist training were used to aid the interview. Data were analysed using reflexive thematic analysis.</p> Results <p>The nurses’ understanding of the meaning of pedagogical encounters with patients in cancer care could be described by one overarching theme “A holistic approach to support patients learning” and five sub-themes: “Supporting patient learning through pedagogical awareness”, “Creating an atmosphere of trust”, “Forming mutual understanding and participation”, “Using personal characteristics and experiences”, and “Engaging in continuous learning and team collaboration”. The nurses’ overarching goal with the pedagogical encounter was to support patients to understand and cope with their situation. They used strategies like active listening, observing non-verbal cues, and seeking feedback to create a supportive, person-centred learning environment. Theoretical knowledge enhanced their awareness of diverse learning methods and how to tailor nursing interactions to individual needs. Still, they emphasized the importance of personal characteristics and experiences over theoretical knowledge, where self-awareness, empathy, and human insight is vital.</p> Conclusion <p>The nurses’ thoughts and actions in their encounters with patients were supported by what they had experienced and studied about learning in the program, their competencies in nursing, and most strongly their own personal qualities and experiences. These are all important sources to support patient learning, but we want to forward the importance of including pedagogical knowledge and practice in health care education. Future research should explore how theoretical knowledge in pedagogy can be better integrated into practice.</p> Clinical trial number <p>Not applicable.</p>