LESSON 2

FUNDAMENTAL PATTERNS OF KNOWING IN NURSING

INTRODUCTION
In healthcare, the fundamental pattern of knowing is a typology that attempts to
classify the different sources from which knowledge and beliefs in professional practice can
be or have been derived. It was proposed by Barbara A. Carper, a professor at the College of
Nursing at Texas Woman’s University, in 1978.
In 1995, Jill White identified another pattern of knowing which is socio-political and in
2008, Chin and Kramer introduced the pattern of emancipatory knowing because of its link to
underlying critical social perspectives and its interference as an outcome of nursing practice.

OUTCOMES
At the end of the lesson, the learners must have:
1. identified the fundamental patterns of knowing in nursing; and
2. compared the fundamental patterns of knowing in nursing.

WARM UP ACTIVITY

Identify the fundamental pattern of knowing exemplified in each situation.

1. Nurse Michael practices nursing interventions based from accepted clinical

practices. _______________________________________
2. Nurse Ace shows compassion, mercy and understanding towards patients, co-
workers and supervisors. _______________________
3. Nurse Ivan explains the concepts behind organ donation to a terminally-ill
patient. _____________________________________
4. Rex, a nursing student, strives to promote a meaningful relationship with his
elderly patient. ___________________________________
5. Luke, a nursing student answers a question posed by the teacher based on what
he learned from nursing school. _________________

LEARNING INPUTS
Read the following materials.

The fundamental pattern of knowing in nursing is a typology that attempts to classify

the different sources from which knowledge and beliefs in professional practice have been
derived. Dr. Barbara A. Carper (1978) identified four fundamental patterns of knowing in
nursing from an analysis of the conceptual and syntactical structure of nursing knowledge.

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The four patterns are distinguished according to logical type of meaning and designated as
empirical, ethical, personal and aesthetics.
In 1995, Jill White identified another pattern of knowing which is socio-political and in
2008, Chin and Kramer introduced the pattern of emancipatory knowing because of its link
to underlying critical social perspectives and its interference as an outcome of nursing
practice. Emancipatory knowing is defined as “the ability to recognize social and political
problems of injustice or inequity, to realize that things could be different, and to identify or
participate in social and political change to improve people’s lives”.

Fundamental Patterns of Knowing in Nursing

• Empirical – the scientific discipline of nursing

• Ethical – the moral directions of nursing

• Personal – method by which nurses approach their clients

• Aesthetics – deals with the emphatic aspect of nursing

• Socio-political /emancipatory– the praxis of nursing

Empirical Knowing

• The principal form relating to factual and descriptive knowing aimed at the
expansion of abstract & theoretical explanations.

• Focuses on evidence-based research for effective and accurate nursing practice

• Emphasizes scientific research is important to nursing knowledge

• First primary model of knowing (Kenney, 1996)

• It is information source or base of knowing obtained from textbooks, lectures,

journals and online resources.

• It is where most theory and research development is concentrated and some

conceptual forms have better capacity to explain nursing phenomena than others

Examples: David, a nursing student answers a question posed by the clinical

instructor based on what he learned from school.

Elmer, a nurse researcher uses scientific method to produce desired study results.

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 Evidence-Based Practice (EBP) as part of Empirical Knowing
• It uses a form of evidence in making clinical judgment.

• Involves accurate and thoughtful decision making about health care delivery
system.

• Based on results of the most relevant and supported evidences.

• Bridges the gap of nursing practice and research.

Six characteristics of Quality Health Care that Reinforces Aspects of EBP

• C=client-centered

• A=attuned with system policies and resources

• S=scientifically-based

• P=population outcome based

• I=individualized to client’s needs

• D=developed thru quality and improvement and bench marking

Aesthetic Knowing
• Related to understanding what is significance to particular clients such as feelings,
attitudes, points of view (Carper, 1978).

• A manifestation of creative and expressive styles of the nurse.( Kenney, 1996)

• Focuses on EMPATHY- the ability for sharing or vividly understanding another’s

feeling. This is the primary form of aesthetic knowing.

• Includes nurse’s ability ways and manner of rendering nursing care.

• Done by knowing the individual distinctively.

• Used in the process of giving appropriate nursing care through understanding the
uniqueness of every patient, thus emphasizing use of creative and practical styles of
care..

Examples: Nurse Xian uses layman terms in explaining the needs of the patient with
right-sided heart failure.

Nurse Ace shows compassion, mercy and understanding towards patients, co-
workers and supervisors.

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Ethical Knowing

• Requires knowledge of different philosophical positions regarding what is good and

right in making moral actions and decisions particularly in the theoretical and clinical
components of nursing.

• Involves knowing the judgment of right and wrong in relation to intentions, reasons
and attributes of individuals and situations.

• Deeply rooted in the concepts of human dignity, service and respect for life.

• Lessening suffering, upholding and preserving health is one of the key elements why
nursing is a core service in society.

• It includes all deliberate nursing actions involving and under the jurisdiction of ethics
and professionalism (Kenney, 1996)

• Code of morals or code of ethics is the main basis for ethical knowing.

Examples: Sir Karlo, a clinical instructor, reprimands a student who cheated on a quiz
and explains the consequences.

Nurse Hero explains the concepts behind organ donation to a terminally-ill patient.

Personal Knowing
• Encompasses knowledge of the self in relation to others and self.

• Involves entirely the Nurse-Patient Relationship.

• Focused on realizing, meeting and defining the real, true self or “self-awareness”

• Involves therapeutic use of self; the key in comprehending health. In terms of

personal well-being

• The most difficult to master and to teach; it takes a lot of time to fully know the nature
of one self in relation to the whole world

• It stresses that human beings are not in a fixed state but are constantly engaged in a
dynamic state of changes (Kenney, 1996)

Examples: Red, a nursing student, strives to promote a meaningful personal

relationship with his elderly patient.

Cyrus, a nursing student, undergoes psychological counseling and self-awareness

sessions before his psychiatric nursing rotation.

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Socio-political/emancipatory
• Nursing politics & policies, developed by means of paying attention to all relevant
voices in healthcare situations so to describe the social, cultural, and political contexts
of nurse-patient interactions and of all healthcare settings

• The praxis of nursing- requires an understanding of how to connect with and motivate
people where they are.

• Occurs on two levels-socio-political contexts of the persons (nurse & patient) & the
socio political context of nursing as a practice profession including both societies
understanding of nursing and nursing’s understanding of society and its politics.

Example: Nurse Leah, actively lobbied and fought for the Salary Grade 15 entry level
for Nurse 1 position in government hospitals and got the approval of the Supreme
Court.

For additional readings, browse the following websites and relevant articles
available in PDF format.

 The fundamental patterns of knowing in nursing

https://nursology.net/nurse-theorists-andtheir-work/fundamental-patterns-
of-knowing-in-nursing/

 Emancipatory knowledge development

https://nursekey.com/emancipatory-knowledge-
development/#::~:text=Emancipatory%20knowing%20is%20the%l20lives

 An Inquiry into “Ways of Knowing in Nursing” by Lee Khuan available in PDF

 Ways of Knowing in Nursing: The Historical Evolution of a Concept by Patricia

E. Zander available in PDF

 Knowing in Nursing: a concept analysis by Susan A. Bonis available in PDF

ACTIVITY 1

1. What are the fundamental patterns of knowing in nursing? Define each.

2. Cite two examples for each pattern of knowing.

Post your answers to the questions on the Discussion Forum 1 created for this lesson (date
to be posted later).

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WRAP UP ACTIVITY

Among the fundamental patterns of knowing, which do you think is the most
important that a nurse should have to provide quality care to patients.
Justify your answer in a reflection paper of about 150 words.

Once finished, take a photo of your output and post it to Discussion Forum 1 intended for this
lesson (date to be posted later).

ASSESSMENT

A summative assessment will be administered to you. Be sure to get at least 60% of

the test items.

REFERENCES
Alligood, Martha Raile. (2018). Nursing Theorists and their Works. 9th edition. Elsevier
(Singapore) Pte. Ltd.
Octaviano, Eufemia F and Carl E. Balita. (2008). Theoretical Foundations of Nursing: The
Philippine perspective. Philippines: Educational Publishing House.
Peterson, Sandra and Bredow, Timothy S. (2017). Middle Range Theories Application to
Nursing Research and Practice 4th edition: China