1. 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.

2. 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

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
The aim of Carper’s theory

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
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

5. 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

6. 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

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

8. 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…

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 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….

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 given situation

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

13. Empirical knowing Positivist science Source of this knowledge
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
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.

15. 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

16. 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