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Nursings fundamental patterns of knowing
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Nursings fundamental patterns of knowing

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  • 1. Carper (1978) Fundamentalpatterns of knowingKnowledge development for a practice discipline
  • 2. The problem of Nursing as apractice discipline◦ Nursing involves processes of dynamic interactions◦ Nurses in practice know more than they can communicate to others◦ Historically what nurses know has not been communicated well◦ Empirical knowledge only partially reflects nursing knowledge◦ This can be improved when all forms of knowing are integrated and valued
  • 3. Why develop patterns of knowing The aim of Carper’s theory was to: ◦ Formally express nursing knowledge ◦ Provide a professional and discipline identity ◦ Convey to others what nursing contributes to healthcare ◦ Create expert and effective nursing practice
  • 4. Knowing and knowledge Knowing and knowledge ◦ Knowing refers to the way of perceiving and understanding self and the world ◦ Knowledge refers to knowing that is expressed in a form that can be shared and communicated to others
  • 5. Nursing’s fundamental patternsof knowing Carper (1978)  Chinn and Kramer ◦ Ethics (2008) ◦ Personal knowing ◦ Emancipatory ◦ Aesthetics Knowing  The praxis of nursing ◦ Empirics
  • 6. Ethics: the component of moralknowledge in nursing  Guides and directs how nurses conduct their practice  Requires ◦ Experiential knowledge of social values ◦ Ethical reasoning  Focus is on: ◦ Matters of obligation, what ought to be done ◦ Right , wrong and responsibility ◦ Ethical codes of nursing ◦ Confronting and resolving conflicting values, norms, interests or principles
  • 7. Sources of Ethical knowing Nursing’s ethical codes and professional standards An understanding of different philosophical positions ◦ Consequentialism ◦ Deontology ◦ Duty ◦ Social justice
  • 8. Personal knowing: acceptance of self thatis grounded in self-knowledge andconfidence Concerned with becoming self-aware ◦ Self–awareness that grows over time through interactions with others Used when nurses engage in the therapeutic use of self in practice ◦ Scientific competence, moral/ethical practice, insight and experience of personal knowing Personal reflection ◦ Informed by the response of others Openness to experience
  • 9. Personal knowing Personal knowing needs to be integrated or reconciled with professional responsibilities Personal Knowing is the basis of the therapeutic use of self in the nurse patient relationship ◦ Perceiving self feelings, and prejudices within the situation
  • 10. Aesthetic knowing: the art ofnursing Expressed through: ◦ Actions, bearing, conduct, attitudes, narrative and interaction ◦ Knowing what to do without conscious deliberation Involves: ◦ Deep appreciation of the meaning of a situation ◦ Moves beyond the surface of a situation ◦ Often shared without conscious exchange of words ◦ Transformative art/acts ◦ Brings together all the elements of a nursing care situation to create a meaningful whole
  • 11. Aesthetic knowing Perceiving the nature of a clinical situation and interpreting this information To respond with skilled action It uses the nurses intuition and empathy Is based on the skill of the nurse in a
  • 12. Empirics: the science of nursing Based on the assumption that what is known is accessible through the physical senses: seeing, touching and hearing. ◦ Reality exists and truths about it can be understood A pattern of knowing that draws on traditional ideas of science Expressed in practice as scientific competence ◦ Competent action grounded in scientific knowledge including theories and formal description ◦ Involves conscious problem solving and logical reasoning
  • 13. Empirical knowing Positivist science ◦ Knowledge is systematically organised into general laws and theories Source of this knowledge ◦ Research ◦ Theory
  • 14. Emancipatory knowing (Chinn and Kramer) Emancipatory knowing addresses the social and political context of nursing and healthcare and critiques the four fundamental patterns of knowing It recognises serious social barriers to health and well-being Emancipatory knowing requires an understanding of the nature of knowledge Praxis is the process of emancipatory knowing. It requires both critical reflection and action
  • 15. Fundamental patterns ofknowing Empiric Emancipatory Ethical Personal Aesthetic
  • 16. Methods of turning knowing intoknowledge Problem based learning ◦ An instructional method in which students work in small groups ◦ Used to gain knowledge and acquire problem-solving skills. Clinical Supervision ◦ An exchange between practicing professionals to enable the development of professional knowledge and skills Structured reflection on practice ◦ John’s (1994) model of structured reflection used Carper’s fundamental patterns of knowing ◦ Section 5 of the model considers learning gained from the experience. It asks “how has this experience changed my ways of knowing?”  Empirics/ Aesthetics/Ethics/Personal

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