Scholarly Reflection on Nursing Practice:
Pamela G. Reed, PhD, RN, FAAN
Nursing, like other professional disciplines, draws from multiple sources of knowledge to inform its practice. Over the years, various models of practice have been used to formalize nursing’s approach to knowledge-based practice, including research-based, theory-guided, and evidence-based models. The intent of this ensemble of student articles is to demonstrate students’ application of a framework of scholarly reflection to gain new insights from their nursing practice experiences. These articles are based upon Honors assignments completed by 11 undergraduate first and second semester nursing students who were enrolled simultaneously in a course on scientific inquiry and a clinical course. The students completed the assignment by working in their clinical groups (for a total of four groups), applying what they were learning theoretically and clinically to generate new ideas about facilitating their patient’s well-being.
Scholarship in nursing
practice requires a diversity of knowledge sources in addition to the empirical
pattern dominant in research studies. In particular, scholarship that occurs in
the context of nursing practice provides the opportunity for a richer and more
immediate understanding of patients than might be realized when knowledge
application is separated from knowledge production (Reed, 2006a).
This ensemble of articles demonstrates knowledge discoveries of first and second
semester undergraduate Honors students during their simultaneous enrollment in a
clinically-based course and a course focused on the process of scientific
inquiry (Reed, 2006b). Students worked in one of four clinical groups, applying
the professor’s Framework of Scholarly Reflection to analyze a current
patient care situation.
The framework incorporates two dimensions: Nursing patterns of knowing and nursing theories. Students used the classic nursing models of Orem, Johnson, and Roy (although any theoretical systems could be used) to help frame understanding of their nursing role and patients’ health experiences. Patterns of knowing were drawn from Carper’s (1978) seminal work on fundamental patterns of knowing – empirical, esthetic, ethical, and personal – along with White’s (1995) sociopolitical pattern of knowing. The patterns of knowing are briefly defined as follows: Empirical – traditional scientific approaches to theory development and research; Esthetic – discovery of new ideas from empathy with patients and direct experiences in practice; Ethical -- focused on moral issues and judgments; Personal – involves an authentic self in interpersonal encounters with others (Carper, 1978); Sociopolitical – the contexts wherein nursing care and the nursing profession are enacted (White, 1995).
Highlights of the results of the students’ inquiry are presented in each student group article below, along with excerpts of the four actual patient situations (with identifying details removed). The four articles demonstrate the variety of clinical insights that can emerge from integrating a diversity of knowledge sources and patterns of knowing available to first and second semester nursing students. The goal was to discover something new, beyond the existing evidence found in the literature, about how they could make a positive difference in their patient’s well-being.
This ensemble of student articles demonstrates how use of diverse dimensions of nursing knowledge can extend evidence-based practice. Reflective inquiry can enrich predetermined foundations of practice found in students’ technical applications of psychomotor skills and research findings. The students’ applications of a Framework of nursing theories and patterns of knowing in reflecting on their clinical practice helped provide them with new insights and innovations for practice.
Carper, B. A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1 (1), 13-23.
Durgahee, T. (1997). Reflective practice: Decoding ethical knowledge. Nursing Ethics, 4 (3), 211-219.
James, C.R., & Clarke, B.A. (1994). Reflective practice in nursing: Issues and implications for nursing education. Nursing Education Today, 14, 82-90.
Peden-McAlpine, C., Tomlinson, P.S., Forneris, S.G., Genck, G., & Meiers, S. (2005). Evaluation of a reflective practice intervention to enhance family care. Journal of Advanced Nursing, 49(5), 494-501.
Reed, P.G. (2006a). The practice turn in nursing epistemology. Nursing Science Quarterly, 19 (1), 36-38.
Reed, P. (2006b) Pam’s Notes: Patterns of knowing. Unpublished paper. University of Arizona College of Nursing, Tucson, AZ.
Schön, D. (1983). The reflective practitioner: How professionals think. New York: Basic Books.
White, J. (1995). Patterns of knowing: review, critique, and update. Advances in Nursing Science, 17 (4), 73-86.
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