1. CCaarrppeerr ((11997788)) FFuunnddaammeennttaall
ppaatttteerrnnss ooff kknnoowwiinngg
Knowledge development for a practice discipline

2. TThhee pprroobblleemm ooff NNuurrssiinngg aass aa
pprraaccttiiccee ddiisscciipplliinnee
◦ 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

3. WWhhyy ddeevveelloopp ppaatttteerrnnss ooff kknnoowwiinngg
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

4. KKnnoowwiinngg aanndd kknnoowwlleeddggee
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

5. NNuurrssiinngg’’ss ffuunnddaammeennttaall ppaatttteerrnnss ooff
kknnoowwiinngg
Carper (1978)
◦ Ethics
◦ Personal knowing
◦ Aesthetics
◦ Empirics
Chinn and Kramer
(2008)
◦ Emancipatory
Knowing
 The praxis of nursing

6. EEtthhiiccss:: tthhee ccoommppoonneenntt ooff mmoorraall kknnoowwlleeddggee
iinn nnuurrssiinngg
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

7. SSoouurrcceess ooff EEtthhiiccaall kknnoowwiinngg
Nursing’s ethical codes and professional
standards
An understanding of different
philosophical positions
◦ Consequentialism
◦ Deontology
◦ Duty
◦ Social justice

8. PPeerrssoonnaall kknnoowwiinngg:: aacccceeppttaannccee ooff sseellff tthhaatt iiss
ggrroouunnddeedd iinn sseellff--kknnoowwlleeddggee aanndd ccoonnffiiddeennccee
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

9. PPeerrssoonnaall kknnoowwiinngg
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. AAeesstthheettiicc kknnoowwiinngg:: tthhee aarrtt ooff nnuurrssiinngg
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

11. AAeesstthheettiicc kknnoowwiinngg
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. EEmmppiirriiccss:: tthhee sscciieennccee ooff nnuurrssiinngg
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

13. EEmmppiirriiccaall kknnoowwiinngg
Positivist science
◦ Knowledge is systematically organised into
general laws and theories
Source of this knowledge
◦ Research
◦ Theory

14. EEmmaanncciippaattoorryy kknnoowwiinngg ((CChhiinnnn aanndd
KKrraammeerr))
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

15. FFuunnddaammeennttaall ppaatttteerrnnss ooff kknnoowwiinngg
Emancipatory
Ethical
Empiric
Personal
Aesthetic

16. MMeetthhooddss ooff ttuurrnniinngg kknnoowwiinngg iinnttoo
kknnoowwlleeddggee
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