A paradigm for the production of practice-based knowledge

Reed, Pamela G.; Lawrence, Lisa

doi:10.1111/j.1365-2834.2008.00862.x

Cited by 38 publications

(34 citation statements)

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“…Numerous aspects related to cognitive capabilities and knowledge influence diagnostic processes [16,17]. Knowledge about a patient’s history and about how to interpret relevant patient information is a central factor in deriving accurate diagnoses [18-20].…”

Section: Introductionmentioning

confidence: 99%

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

et al. 2012

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BackgroundThis paper reports a study about the effect of knowledge sources, such as handbooks, an assessment format and a predefined record structure for diagnostic documentation, as well as the influence of knowledge, disposition toward critical thinking and reasoning skills, on the accuracy of nursing diagnoses.Knowledge sources can support nurses in deriving diagnoses. A nurse’s disposition toward critical thinking and reasoning skills is also thought to influence the accuracy of his or her nursing diagnoses.MethodA randomised factorial design was used in 2008–2009 to determine the effect of knowledge sources. We used the following instruments to assess the influence of ready knowledge, disposition, and reasoning skills on the accuracy of diagnoses: (1) a knowledge inventory, (2) the California Critical Thinking Disposition Inventory, and (3) the Health Science Reasoning Test. Nurses (n = 249) were randomly assigned to one of four factorial groups, and were instructed to derive diagnoses based on an assessment interview with a simulated patient/actor.ResultsThe use of a predefined record structure resulted in a significantly higher accuracy of nursing diagnoses. A regression analysis reveals that almost half of the variance in the accuracy of diagnoses is explained by the use of a predefined record structure, a nurse’s age and the reasoning skills of `deduction’ and `analysis’.ConclusionsImproving nurses’ dispositions toward critical thinking and reasoning skills, and the use of a predefined record structure, improves accuracy of nursing diagnoses.

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Section: Introductionmentioning

confidence: 99%

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

et al. 2012

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“…One fundamental characteristic of a profession is that its knowledge base is constantly evolving. 20 The aim of contemporary philosophy of science in nursing would do well to transform abstract concepts into ideas that are more accessible for practice. 21,22 Pedagogy that implements critical thinking skills is essential for future competence and practice in the contemporary milieu of a complex health care environment.…”

Section: Discussionmentioning

confidence: 99%

Utilizing a logic model to identify clinical research problems: a lesson from philosophy of science

Collins¹

2016

NRR

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Communication and decision making in the health care workplace often involve finding solutions to ill-structured problems in uncertain, dynamic environments influenced by the competing interests of multiple stakeholders. In this environment, doctoral-prepared nurses who practice as administrators, policy makers, or advanced practice practitioners are often compelled to make important decisions based upon evaluating the merit of colleagues' proposals against some desired organizational or population outcome. Of equal importance is the nurse leader's own capacity to construct a compelling argument or proposal that will drive the organization forward to meet the evolving needs for quality health care. Where do we learn the skills necessary to foster this kind of critical thinking in our professional communications? The author suggests that one teaching-learning approach can be found through the thoughtful application of the work of British philosopher Steven Toulmin. Toulmin defined a model for both the analysis and derivation of logical arguments or proposals that can be readily learned and applied for use in health care systems. This model posits that a substantive argument or claim can be evaluated based on the assumptions it presumes (warrants) and the strength of the evidence base (backing). Several of the social science professions have adapted Toulmin's model to generate analysis and creative solutions to complex or emergent problems. The author proposes that an application of this model be included in the pedagogy of doctoral level Philosophy of Science or Nursing Theory courses. The Toulmin process often provides the doctoral student or novice researcher with their first real learning experience in defining the scope and inherent challenges of framing a clinical issue to be the focus of their scholarly translational projects. Several illustrations, which were eventually researched and further developed for capstone scholarly projects, are presented as exemplars of this process.

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“…Even more concerning is that while there is a general acceptance of the two ‘kinds’ of knowledge, there remains a lingering frustration with the fact that ‘nothing has been said about how the integration [between kinds] works’ (Risjord, , p. 55): how they connect and interact, and with what consequences for nurses and patients. It can be argued that most scholars have simply accepted the ‘impossibility’ of forging a connection between knowledge kinds and have therefore championed a ‘pluralistic view of nursing knowledge’ (Reed & Lawrence, , p. 425) that does not seek integration. However, it is important to note that this acceptance has some unsettling consequences.…”

Section: Epistemic Knowledge ‘Kinds’ In Nursingmentioning

confidence: 99%

Reconciling nursing's art and science dualism: Toward a processual logic of nursing

Bender

Holmes

2019

Nursing Inquiry

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There is an enduring debate in nursing regarding the art–science dualism, involving an articulation of two distinct ‘kinds’ of disciplinary knowledge: objective/scientific and subjective/artistic. Nursing identifies both as necessary, yet unbridgeable, which creates problems in constructing a coherent disciplinary knowledge base. We describe how this problem arises based on an ontological assumption of two different kinds of ‘stuff’ in the world: that with essential determinate properties and that without essential properties. We experiment with a solution by ontologically understanding the world as made from a single kind: That the most irreducible element of the world is process, in that reality is a continuous construction whereby subject and object are products, not independent constituents, of reality. Process philosophy overcomes nursing's ontological bifurcation and enables nursing's art–science dualism to be re‐conceptualized as a cohesive logic of skilled reality production. An unavoidable implication of a process turn in nursing philosophy is that the disciplinary goal no longer becomes a privileged ‘body of knowledge’ that authorizes, which has always been a defining challenge in nursing. Rather, and more productively perhaps, the aim is for greater sophistication and plurality in its ongoing commitment to attuning to reality in ways that shape disciplinary attainment.

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A paradigm for the production of practice-based knowledge

Abstract: Nursing managers can influence if not facilitate all of the strategies to promote practice-based knowledge development identified in the paper. These efforts could give voice to the caregiver's knowledge and, in turn, enhance patient care and the satisfaction and retention of nurses.

Cited by 38 publications

References 35 publications

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

Do knowledge, knowledge sources and reasoning skills affect the accuracy of nursing diagnoses? a randomised study

Utilizing a logic model to identify clinical research problems: a lesson from philosophy of science

Reconciling nursing's art and science dualism: Toward a processual logic of nursing

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