Carper (1978)

Fundamental patterns of
knowing
Knowledge development for a practice
discipline

4 PATTERNS OF KNOWING
NURSING SCIENCE
Nursing Ethics
Nursing esthetics
Personal knowledge

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

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

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

Nursings fundamental
patterns of knowing
Carper

(1978)

Ethics
Personal knowing
Aesthetics
Empirics / Science

Chinn

and
Kramer (2008)
Emancipatory
Knowing
The praxis of
nursing

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

Sources of Ethical
knowing
Nursings

ethical codes and

professional standards
An understanding of different
philosophical positions

Consequentialism
Deontology
Duty
Social justice

Personal knowing: acceptance of self

that is 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 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
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
HERE & NOW

Aesthetic knowing
Perceiving

the nature of a clinical

situation and interpreting this
information

To
It
Is

respond with skilled action

uses the nurses intuition and empathy

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

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

Empirical knowing
Positivist

science

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

Fundamental patterns of
knowing
Empiric

Ethical

Emancipatory

Aesthetic

Personal

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