Using reflection within a metacognitive model this paper aims to explore and discuss two recently developed approaches to flexible education. The increasing number of new nursing roles coupled with a dramatically changing health care environment determines the need for educational approaches that recognise and value learning in daily practice. By presenting a lecturer's and a student's reflections of two such approaches (accredited work-based learning at level 2/3 and the MA Advanced Practice) within one paper we have sought to capture the essence of learning that occurs at the interface between patient care and nurse education at three different academic levels and from two different perspectives. From the lecturer's perspective, the pivotal role that work-based learning approaches can play in the ongoing development of health care is identified. The importance of collaboration in developing and delivering accredited work-based learning is recognised and the value of reflection in and on practice when facilitating the learning of work-based students has been demonstrated. The lecturer's development of a facilitative teaching style is argued to be as important as the student's development of reflective skills in order that education and practice can grow together. From the students perspective, completing the MA Advanced Practice fostered integration between theory and practice, alongside the opportunity for cross-fertilisation of ideas between two traditionally different practitioners of nursing and medicine. This exposed several benefits within clinical practice for the client group that the practice project was aimed at and the development of a more holistic understanding of the clinical experience as it related to individual learning, self-reflection and self-awareness.