Nursing is Inquiry in Practice:
Meaning and Legitimate Knowledge
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Overview
"Foucault maintains that power is a feature of all discursive practices, and
although often misunderstood as a human or institutional property, is actually
a function of knowledge. As Foucault explains, it is through discursive activity
that knowledge is legitimated and power is bestowed. However, rhetorical
processes that give rise to knowledge at once also give rise to power. In other
words, knowledge both creates and is created by power."
- Brown & Marston (1997).
A study of the nature and evolution of science is essential to understand the impact of scientific philosophy on the development of knowledge in a discipline. Knowledge in any discipline develops as a result of the systematic examination of the phenomena of concern. Systematic study in any discipline is guided by a view of science as a process of inquiry that recognizes a number of equally legitimate approaches to the study of the phenomena of concern.
Epistemology is a branch of philosophy that studies the nature and limits of knowledge; it examines the structure, origin, and criteria of knowledge. Epistemology also deals with a number of related problems: sense perception, the relation between the knower and the object known, the possible kinds of knowledge and the degrees of certainty for each kind of knowledge, the nature of truth, and the nature of and justification for inferences. The word epistemology comes from the Greek words episteme ("knowledge") and logos ("theory"). A common definition of epistemology is the "theory of knowledge".
Empiricism is the name of a broad tradition in Western philosophy. The term comes from the Greek empeiria, meaning "experience"; the basic thesis of empiricism is that legitimate human knowledge arises from what is provided to the mind by the senses or by introspective awareness through experience. Most empiricists do not consider knowledge gained through the imagination, authority, tradition, or pure theoretical reasoning as legitimate. Hence, they tend to regard traditional claims to knowledge in such fields as art, morality, religion, and metaphysics as unverifiable.
Nursing knowledge is simultaneously the laws and relationships that exist between the elements that describe the phenomena of concern in nursing (factual knowledge) and the laws or rules that the nurse uses to combine the facts to make clinical nursing decisions. An example of factual knowledge is knowledge established by research. An example of the laws is an expert clinician's set of heuristics, or "rules of thumb" for practice. Although the two examples seem different, the difference is not crucial to understanding processing operations. Both forms of knowledge deal with laws and relationships that connect the elements of nursing data. What differs is the level of confidence possible about the accuracy of the rules.
Knowledge has the attributes of accuracy, utility (relevance and quality) and type. Although the definitions of accuracy and utility are apparent, the idea of types of knowledge is new. Four ways of "knowing" are acknowledged as being central to nursing practice: (a) empirical, (b) ethical, (c) personal, and (d) aesthetic (Carper, 1978).
By describing permissible operations for each way of knowing, Kramer and Chinn (1988) elaborated on Carper's patterns of knowing in a way that is analogous to the concept of "data-type" in computational science. Each knowledge pattern is defined by a conceptual description and also by what can be considered "permissible processing operations": parameters, conditions and methods for generating, verifying and transmitting each pattern of knowing. Because of this analogous treatment of ideas of knowledge and data, it is reasonable to assume the attribute "knowledge-type" and to treat the patterns of knowing as knowledge-types, each having permissible processing operations for the generation, verification and transmission of the knowledge.
Ends In View
This learning activity is intended to provide learners with the opportunity to:
1. Recognize the historical and traditional foundation of legitimate knowledge in nursing.
2. Explore the empirical, ethical, personal and aesthetic ways of knowing and their applications to legitimate knowledge in nursing.
3.Comprehend the epistemological and empirical aspects of nursing science.
4. Consider the relevance of legitimate knowledge to the education of professional nurses.
In Preparation
1.READ: Heath, H. (1998). Reflection and patterns of knowing in nursing. Journal of Advanced Nursing, 27, 1054 – 1059.
2. READ: Apple, M. (1999). What counts as legitimate knowledge? The social production and use of reviews. Review of Educational Research, 69 (4), Winter, 343 – 346.
3.READ: Hildreth, P., & Kimble, C. (2002). The duality of knowledge. Information Research, 8 (1), paper no. 142.
In Practice
1. Participate in group discussion on the topics of legitimate knowledge and the meaning these have for nursing as a practice, as a science, and as a discipline.
2. With a partner, create a graphic representation of the four different ways of knowing in nursing, described by Carper. This can be a model, a concept map, a shield, or a full drawing. Your goal is to create a visual explanation of how all four of these ways are important for nursing. Share your work with the rest of the class.
3. Heath describes a fifth dimension that was added to Carper's model by Jill White (1995) called the Socio-Political Knowing and Reflection dimension. How does this dimension fit the Canadian Nurses Code of Ethics that mandates that all nurses must work for social justice to the best of their capacity?
“Nurses uphold principles of equity and fairness to assist persons in receiving a share of health services and resources proportionate to their needs and in promoting social justice.” (CNA, 2002, p. 8).
4. Discuss the types of knowledge posed by Hildreth & Kimble.
In Reflection
1. Reflect on your own practice. How do YOU express the (a) empirical, (b) ethical,
(c) personal, and (d) aesthetic aspects of nursing?
2. How can you broaden the knowledge you receive during your nursing education, beyond what is written in your textbooks? Are there advantages to doing this? What are they?
References
Apple, M. (1999). What counts as legitimate knowledge? The social production and use of reviews. Review of Educational Research, 69 (4), Winter, 343 – 346.
Brown, N.A. & Marston, P. (1997). The Co-production of knowledge and power: A postmodern critique of tenure. Enculturation, 1 (1), Spring.
Carper, B.A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1, 13-24.
Canadian Nurses Association. (2002). Code of Ethics for Registered Nurses. Ottawa: Canadian Nurses Association.
Heath, H. (1998). Reflection and patterns of knowing in nursing. Journal of Advanced Nursing, 27, 1054 – 1059.
Hildreth, P., & Kimble, C. (2002). The duality of knowledge. Information Research, 8 (1), paper no. 142.
Hiraki, Akemi. (1992). Tradition, rationality and power in introductory nursing textbooks: A critical hermeneutics study. Advances in Nursing Science, 13 (3), p. 1-12.
Kramer, M., & Chinn, P.L. (1988). Perspectives on knowing: A model of nursing knowledge. Scholarly Inquiry in Nursing Practice, 2, 129-139.
White, J. (1995). Patterns of Knowing: Review, Critique, and Update. Advances in Nursing Science, 17 (4), p. 73-86.
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Welcome to NRSG 3225!
Powerpoint
Powerpoint as PDF
Cultural Knowing: Professional and Research Culture
GROUP WORK
GROUP 1
GROUP 2
GROUP 3
WEB MANUAL
The course Web design manual can be accessed from this page.
You are encouraged to begin to think about the type of Nursing Inquiry focus you wish to address as the context for your major assignments in this course. We will build up to this practical application of the content early in the course. Try to make it a meaningful focus that you can actually use in your current or future practice.
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