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AIMS AND OBJECTIVES The aim was to explore how nursing students perceive and use the conceptual Fundamentals of Care framework in case-based work in nursing education. Furthermore, to describe influencing factors on perceptions and use of the framework. BACKGROUND The Fundamentals of Care framework has been integrated in core courses in two schools of nursing in Region North Denmark in response to studies reporting that nursing students and newly graduated nurses lack the knowledge, skills and competencies to meet the challenges of delivering fundamental care in clinical practice. An integration of the framework in case-based work in nursing education has not previously been studied. DESIGN AND METHODS The study design was focused ethnography. Data was collected using participant observations, focus group interviews and individual interviews. Four groups of four to five nursing students participating in case-based work sessions and three faculty members from two Schools of Nursing were included. The study adhered to COREQ. RESULTS The results show an uncertainty among the students about how to understand and use the conceptual framework in case-based work. The uncertainties derive from diversities in faculty members' perceptions and curricular planning among others. However, the framework appears to support the students' learning about what nursing is and requires. CONCLUSIONS The study indicates that integrating Fundamentals of Care framework in case-based work may be one way of teaching nursing students the complexities of integrated fundamental nursing care. However, there is a need to consider how to support students in articulating Fundamentals of Care, and to draw attention to the influence of role models and curricular planning. RELEVANCE TO EDUCATIONAL PRACTICE The study provides knowledge relevant when customizing future educational interventions regarding the integration of Fundamentals of Care in nursing education and may provide valuable knowledge of evaluation strategies.