Personal knowledge refers to the way in which nurses view themselves and the client.
Personal knowledge is subjective and promotes wholeness and integrity in personal encounters. Engagement, rather than detachment, is a component of personal knowledge.
Personal knowledge incorporates experience, knowing, encountering, and actualizing the self within the practice. Personal maturity and freedom are components of personal knowledge, which may include spiritual and metaphysical forms of knowing. Because personal knowledge is difficult to express linguistically, it is largely expressed in personality (Carper, 1978, 1992).
Ethics refers to the moral code for nursing and is based on obligation to service and respect for human life. Ethical knowledge occurs as moral dilemmas arise in situations of ambiguity and uncertainty and when
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consequences are difficult to predict. Ethical knowledge requires rational and deliberate examination and evaluation of what is good, valuable, and desirable as goals, motives, or characteristics (Carper, 1978, 1992). Ethics must address conflicting norms, interests, and principles and provide insight into areas that cannot be tested.
Fawcett, Watson, Neuman, Walkers, and Fitzpatrick (2001) stress that integration of all patterns of knowing is essential for professional nursing practice and that no one pattern should be used in isolation from others. Indeed, they are interrelated and interdependent because there are multiple points of contact between and among them (Carper, 1992). Thus, nurses should view nursing practice from a broadened perspective that places value on ways of knowing beyond the empirical (Silva, Sorrell, & Sorrell, 1995). Table 1-4 summarizes selected characteristics of Carper’s patterns of knowing in nursing.
Table 1-4 Characteristics of Carper’s Patterns of Knowing in Nursing Pattern of Knowing
Relationship to Nursing
Source or Creation
Source of Validation
Method of Expression
Purpose or Outcome
Empirics Science of nursing Direct or indirect observation and measurement
Replication Facts, models, scientific principles, laws statements, theories, descriptions
Description, explanation, prediction
Esthetics Art of nursing Creation of value and meaning, synthesis of abstract and concrete
Appreciation; experience; inspiration; perception of balance, rhythm, proportion, and unity
Appreciation; empathy; esthetic criticism; engaging, intuiting, and envisioning
Move beyond what can be explained, quantitatively formulated, understanding, balance
Personal knowledge Therapeutic use of self
Engagement, opening, centering, actualizing self
Response, reflection, experience
Empathy, active participation
Promote wholeness and integrity in personal encounters
Ethics Moral component of nursing
Values clarification, rational and deliberate reasoning, obligation, advocating
Dialogue, justification, universal generalizability
Principles, codes, ethical theories
Evaluation of what is good, valuable, and desirable
Sources: Carper (1978, 1992); Chinn and Kramer (2015).
Other Views of Patterns of Knowledge in Nursing Although Carper’s work is considered classic, it is not without critics. Schultz and Meleis (1988) observed that Carper’s work did not incorporate practical knowledge into the ways of knowing in nursing. Because of this and other concerns, they described three patterns of knowledge in nursing: clinical, conceptual, and empirical.