Carper (1978) Fundamental patterns of knowing Knowledge development for a practice discipline

4 PATTERNS OF KNOWING NURSING SCIENCENursing EthicsNursing estheticsPersonal knowledge

The problem of Nursing as a practice discipline Nursing involves processes of dynamic interactionsNurses in practice know more than they can communicate to othersHistorically what nurses know has not been communicated wellEmpirical knowledge only partially reflects nursing knowledgeThis can be improved when all forms of knowing are integrated and valued

Why develop patterns of knowing

The aim of Carpers theory was to:Formally express nursing knowledgeProvide a professional and discipline identityConvey to others what nursing contributes to healthcareCreate expert and effective nursing practice

Knowing and knowledgeKnowing 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

Nursings fundamental patterns of knowingCarper (1978)EthicsPersonal knowingAestheticsEmpirics / Science

Chinn and Kramer (2008)Emancipatory KnowingThe praxis of nursing

Ethics: the component of moral knowledge in nursing Guides and directs how nurses conduct their practiceRequires Experiential knowledge of social valuesEthical reasoningFocus is on: Matters of obligation, what ought to be doneRight , wrong and responsibility Ethical codes of nursingConfronting and resolving conflicting values, norms, interests or principles

Sources of Ethical knowingNursings ethical codes and professional standardsAn understanding of different philosophical positions ConsequentialismDeontology DutySocial justice

Personal knowing: acceptance of self that is grounded in self-knowledge and confidence Concerned with becoming self-awareSelfawareness that grows over time through interactions with othersUsed when nurses engage in the therapeutic use of self in practiceScientific competence, moral/ethical practice, insight and experience of personal knowingPersonal reflectionInformed by the response of othersOpenness to experience

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 relationshipPerceiving self feelings, and prejudices within the situation

Aesthetic knowing: the art of nursing Expressed through:Actions, bearing, conduct, attitudes, narrative and interactionKnowing what to do without conscious deliberationInvolves: Deep appreciation of the meaning of a situation Moves beyond the surface of a situationOften shared without conscious exchange of wordsTransformative art/actsBrings together all the elements of a nursing care situation to create a meaningful whole HERE & NOW

Aesthetic knowingPerceiving 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 given situation

Empirics: the science of nursingBased 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 understoodA pattern of knowing that draws on traditional ideas of scienceExpressed in practice as scientific competenceCompetent action grounded in scientific knowledge including theories and formal descriptionInvolves conscious problem solving and logical reasoningNursing theory

Empirical knowingPositivist scienceKnowledge is systematically organised into general laws and theories

Source of this knowledgeResearchTheory

Emancipatory knowing (Chinn and Kramer)Emancipatory knowing addresses the social and political context of nursing and healthcare and critiques the four fundamental patterns of knowingIt recognises serious social barriers to health and well-beingEmancipatory knowing requires an understanding of the nature of knowledgePraxis is the process of emancipatory knowing. It requires both critical reflection and action

Fundamental patterns of knowing

Emancipatory EthicalEmpiricPersonalAesthetic

Methods of turning knowing into knowledgeProblem based learningAn instructional method in which students work in small groupsUsed to gain knowledge and acquire problem-solving skills.Clinical SupervisionAn exchange between practicing professionals to enable the development of professional knowledge and skillsStructured reflection on practiceJohns (1994) model of structured reflection used Carpers 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

I have been asked to give a brief overview of Carpers fundamental patterns of knowing and demonstrate how Chinn and Kramer have developed these patterns of knowing by adding emancipatory knowledge to the original theory. *Chinn and Kramer believe that the problem with nursing as a practice discipline is nurses know more than they can communicate to others*The aim of Carpers theory*Carper, Chinn and Krammer come from the premise that nursing involves a dynamic process of interactions that can only be understood through the fundamental patterns of knowingThey als define knowing and knowledge *Carpers original work is quite old but within the different theories of nursing it has stood the test of time. Carper has 4 fundamental patterns of knowing. The additional, pattern of knowing emancipatory knowing was not added until 2008*I am sure you do not need me to explain ethics as a pattern of knowing*Personal knowing is concerned with*Aesthetic knowing the art of nursing is expresses.*Finally empirics the science of nursing that is based.*The additional fundamental pattern of knowing was added because it is said to reflect nursings understanding of the social context in which care is given affects the health and well-being of individuals and groups.*This slide puts the five fundamental patterns of knowing together showing how they are 5 individual but interlinking patterns.*Just as food for thought the literature suggests these methods to turn knowing into knowledge*