Post on 04-Jun-2018
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Carper (1978) Fundamental
patterns of knowing
Knowledge development for a practice discipline
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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 reflectsnursing knowledge
This can be improved when all forms of
knowing are integrated and valued
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Why develop patterns of knowing
The aim of Carpers 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
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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 sharedand communicated to others
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Nursings fundamental patterns
of knowing
Carper (1978)
Ethics
Personal knowing
Aesthetics
Empirics
Chinn and Kramer
(2008) Emancipatory
Knowing
The praxis of nursing
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Ethics: the component of moralknowledge in nursing
Guides and directs how nurses conducttheir 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
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Sources of Ethical knowing
Nursings ethical codes andprofessional standards
An understanding of different
philosophical positions Consequentialism
Deontology
Duty Social justice
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Personal knowing: acceptance of self thatis grounded in self-knowledge and
confidence
Concerned with becoming self-aware Selfawareness that grows over time through
interactions with others
Used when nurses engage in thetherapeutic 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
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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
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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 ofwords
Transformative art/acts
Brings together all the elements of a nursing care
situation to create a meaningful whole
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Aesthetic knowing
Perceiving the nature of a clinicalsituation and interpreting this
information
To respond with skilled action
It uses the nurses intuition andempathy
Is based on the skill of the nurse in a
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Empirics: the science of nursing
Based on the assumption that what is knownis 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 formaldescription
Involves conscious problem solving and logicalreasoning
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Empirical knowing
Positivist science Knowledge is systematically organised
into general laws and theories
Source of this knowledge
Research
Theory
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Emancipatory knowing (Chinn
and Kramer)
Emancipatory knowing addresses thesocial and political context of nursing andhealthcare 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 reflectionand action
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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 Johns (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