Nursing Epistemology
Nursing epistemology has been defined as “the study of the origins of nursing knowledge, its structure and methods, the patterns of knowing of its members, and the criteria for validating its knowledge claims” (Schultz & Meleis, 1988, p. 217). Like most disciplines, nursing has both scientific knowledge and knowledge that can be termed conventional wisdom (knowledge that has not been empirically tested).
Traditionally, only what stands the test of repeated measures constitutes truth or knowledge. Classical scientific processes (i.e., experimentation), however, are not suitable for creating and describing all types of knowledge. Social sciences, behavioral sciences, and the arts rely on other methods to establish knowledge. Because it has characteristics of social and behavioral sciences, as well as biologic sciences, nursing must rely on multiple ways of knowing.
In a classic work, Carper (1978) identified four fundamental patterns for nursing knowledge: (1) empirics —the science of nursing, (2) esthetics—the art of nursing, (3) personal knowledge in nursing, and (4) ethics— moral knowledge in nursing.
Empirical knowledge is objective, abstract, generally quantifiable, exemplary, discursively formulated, and verifiable. When verified through repeated testing over time, it is formulated into scientific generalizations, laws, theories, and principles that explain and predict (Carper, 1978, 1992). It draws on traditional ideas that can be verified through observation and proved by hypothesis testing.
Empirical knowledge tends to be the most emphasized way of knowing in nursing because there is a need to know how knowledge can be organized into laws and theories for the purpose of describing, explaining, and predicting phenomena of concern to nurses. Most theory development and research efforts are engaged in seeking and generating explanations that are systematic and controllable by factual evidence (Carper, 1978, 1992).
Esthetic knowledge is expressive, subjective, unique, and experiential rather than formal or descriptive. Esthetics includes sensing the meaning of a moment. It is evident through actions, conduct, attitudes, and interactions of the nurse in response to another. It is not expressed in language (Carper, 1978).
Esthetic knowledge relies on perception. It is creative and incorporates empathy and understanding. It is interpretive, contextual, intuitive, and subjective and requires synthesis rather than analysis. Furthermore, esthetics goes beyond what is explained by principles and creates values and meaning to account for variables that cannot be quantitatively formulated (Carper, 1978, 1992).