Ways of Knowing in Nursing: The Historical Evolution of a Concept

Headnote

Abstract:

Using Rodger's (2000) model of concept analysis the historical evolution of ways of knowing in nursing will be discussed. The ways of knowing in nursing will be explored through their antecedents of learning styles and knowledge, their attributes, and their consequences. The primary focus of the article is the four ways or patterns of knowing in nursing identified by Carper (1978) which have become known as nursing's epistemology. Jacobs-Kramer and Chinn (1997) later described these elements of the epistemology in depth with Silva, Sorrell, and Sorrell (1995) using them to explicate the ontology of nursing.

Key words: Nursing, Historical Evolution of Concept, Ways of Knowing

In 1978, Carper wrote that nursing sought to develop a holistic, individualistic, and therapeutic model of practice that took the profession away from the autocratic, reductionist, and behaviorist characteristics of the medical model. This futuristic evolution of nursing called for a shift away from the ontological and epistemological assumptions associated with "old school' nursing and nursing education toward a more flexible paradigm. In order to be able to make this dramatic shift, Carper proposed that four ways or patterns of knowing be utilized to structure nursing education and evaluate nursing practice. These patterns or ways of knowing were empirics, ethics, esthetics, and personal. Since the publication of Carper's seminal work, many authors have focused on the four patterns collectively and individually in order to further define and describe them; there have been others (e. g. Benner, 1982, 1983; Munhall, 1993; Rew, 1986; White, 1995; Young, 1987) who have proposed additional ways of knowing. These multiple viewpoints will be presented in an analysis of what has come to be known as the epistemological and ontological foundation of nursing.

Using the evolutionary model of concept analysis (Rodgers, 2000), ways of knowing in nursing will be explored through their antecedents, attributes, and consequences; exemplars will be provided to illustrate the various ways of knowing in nursing practice. The evolutionary model was chosen because it perceives concepts to be dynamic entities whose attributes are not stable but are in continuous flux and in need of "purposeful redefinition to maintain a useful, applicable, and effective concept" (Rodgers, p. 81). Nursing is a dynamic profession and therefore needs continual exploration of the various concepts...