The Four Ways of Knowing
include:
Empirical – The scientific discipline of nursing
Ethical – The moral directions of Nursing
Esthetics – Deals with the empathic aspects of
nursing
Personal – Method by which nurses approach their
parents
What is Empirical knowing?
Empirical Knowing is the pattern of knowing that draws on the
traditional ideas of science. It relies on what can be seen, heard or
touched. Empirical Knowing is the principal form relating factual
and descriptive aimed at the expansion of abstract and theoretical
explanation.
• It is where most theory and research development is
concentrated and some conceptual forms have better capacity
to explain nursing phenomena than others.
• Empirical Knowing is the first primary model of knowing(Kenney,
1996).
• Empirical Knowing focuses on evidence-based research for
effective and accurate nursing practice.
Evidence-Based Practice (EBP) as
part of Empirical Knowing
Evidence-Based Nursing Practice involves accurate
and thoughtful decision making about health care
delivery for clients. Nurses of today are active in creating,
publishing and applying research in order to enhance
client care and broaden nursing scientific knowledge
base. It uses a form of evidence in making clinical
judgment. This evidence or support may stem from
tradition, authority, experience, trial and error, logic or
reason and research.
Evidence-Based Practice (EBP) as
part of Empirical Knowing
Evidence-based practice (EBP) promotes quality
care that has been demonstrated to be effective. If
practice guidelines do not exist for a specific problem,
the nurse should look for relevant evidence in studies,
integrate reviews and analysis and assess the quality of
evidence.
Six Characteristics of Quality Health
Care that Reinforces Aspects of EBP
• Client-centered
• Scientifically based
• Population outcome based
• Developed through quality improvement and
benchmaking
• Individualized to client’s need
• Attuned with system policies and resources
What are Evidence Reports?
According to Benefield (2002), Evidence
Report is comprised of knowledge synthesis,
review, and documentation of how evidence-
based practices are being implemented in the
clinical area. He added that it can also include
discussion of the clinical significance and
usefulness of such practices.
What are Evidence Reports?
In the application of Evidence Based Practice,
the nurse should first become aware of the need
for information. Development of a question or
problem statement to address the need is the
next step in the process. Once the question is
defined, the nurse should conduct a systematic
review on research studies that has been done on
the particular topic.
What are Evidence Reports?
Take note that systematic review is different from
literature review in the sense that the former utilizes all
relevant literature from multiple sources which later
undergoes rigorous and systematic evaluation. After the
review and analysis of data, the nurse must now
determine what the research demonstrates and must
decide the level of evidence in order to make
recommendations to promote evidence-based practice. A
structured research summary statement should briefly
describe the evidence reports.
The analysis of the scientific data
describes the following:
• Review of a variety of published and
unpublished research studies
• The details of the analysis
• Target population included in the study
• Types of clinical interventions investigated
• Strengths of individual and collective study
results
What is Ethical knowing?
Ethical knowing is the component of moral knowledge in
nursing. It provides standards and specific ways to deal with any
situation that a nurse might encounter in professional practice.
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.
• The code of morals or code of ethics that leads the conduct of
nurses is the main basis for Ethical knowing.
• Lessening suffering, upholding and preventing 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).
Ethical Knowing involves the
judgement of right and wrong in
relation to, reasons and attributes
of individuals and situations.
What is Esthetic Knowing?
Esthetic knowing is related to understanding what is of
significance to particular patients such as feelings, attitudes,
points of view (Carper, 1978). It is also the manifestation of
the creative and expressive styles of the nurse (Kenney, 1996).
• Esthetic knowing focuses on empathy – the ability for sharing or
vividly understanding another’s feeling. This is the primary form of
aesthetic knowing.
• It also includes the nurse’s ability in changing ways and manner of
rendering nursing care based on the client’s individual needs and
perceptions.
Aesthetic knowing is used in the
process of giving appropriate
nursing care through
understanding the uniqueness of
every patient, thus emphasizing of
creative and practical styles of care
What is Personal Knowing?
Personal knowing is the basis of the therapeutic use of self in the nurse
patient relationship. It involves perceiving self feelings and prejudice within the
situation. Personal Knowing encompasses knowledge of the self in relation to
others and to self. It involves the entirety of Nurse-Patient relationship.
• It is the key to comprehending health in terms of personal well-being.
• It involves therapeutic use of self.
• It takes a lot of time to fully know the nature of oneself in relation to the
world around.
• It stresses that human beings are not in a fixed state but are constantly
engaged in a dynamic state of changes(Kenney, 1996).
Personal Knowledge is focused
on realizing, meeting and defining
the real, true self. One nursing term
defines this as self-awareness
• To avoid patterns going wild
• To acknowledge importance of learning
that occurs outside academic setting
• To promote congruence between nursing
practice and research/theory (knowledge
development)
• To provide professional identity telling
other what we contribute to the health
care process
• To stimulation critical reflection and
thinking (thinking about how
assumptions, definitions and
relationships between patterns of
knowing can be challenged)
• To improve nursing practice
• To assist with the expression of nursing
knowledge
• To promote coherence of professional
purpose, our collective identity
