Carper (1978) Fundamental patterns of knowing Knowledge development for a practice discipline I have been asked to give a brief overview of Carper’s fundamental patterns of knowing and demonstrate how Chinn and Kramer have developed these patterns of knowing by adding emancipatory knowledge to the original theory.

The problem of Nursing as a practice 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 Chinn and Kramer believe that the problem with nursing as a practice discipline is nurses know more than they can communicate to others

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 The aim of Carper’s theory

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 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 knowing They als define knowing and knowledge

Nursing’s fundamental patterns of knowing Carper (1978) Ethics Personal knowing Aesthetics Empirics Chinn and Kramer (2008) Emancipatory Knowing The praxis of nursing Carper’s 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

Ethics: the component of moral knowledge 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 I am sure you do not need me to explain ethics as a pattern of knowing

Sources of Ethical knowing Nursing’s ethical codes and professional standards An understanding of different philosophical positions Consequentialism Deontology Duty Social justice

Concerned with becoming self-aware Personal knowing: acceptance of self that is grounded in self-knowledge and confidence 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 Personal knowing is concerned with…

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

Aesthetic knowing: the art of nursing 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 Aesthetic knowing the art of nursing is expresses….

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 given situation

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 Nursing theory Finally empirics the science of nursing that is based….

Empirical knowing Positivist science Source of this knowledge Knowledge is systematically organised into general laws and theories Source of this knowledge Research Theory

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 The additional fundamental pattern of knowing was added because it is said to reflect nursing’s understanding of the social context in which care is given affects the health and well-being of individuals and groups.

Fundamental patterns of knowing Empiric Emancipatory Ethical Personal This slide puts the five fundamental patterns of knowing together showing how they are 5 individual but interlinking patterns. Aesthetic

Methods of turning knowing into knowledge 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 Just as food for thought the literature suggests these methods to turn knowing into knowledge